Prostatectomy vs. Watchful Waiting in Early Prostate Cancer: An Update

In 2002, Scandinavian researchers reported outcomes for 695 men with early prostate cancer who had been randomized to either radical prostatectomy or watchful waiting (Journal Watch Sep 20 2002). After an average follow-up of 6 years, prostate cancer mortality — but not all-cause mortality — was significantly lower with prostatectomy than with watchful waiting. Now, the investigators have reported outcomes after a median follow-up of 8.2 years.

For each of the four main endpoints, the estimated 10-year cumulative incidence was significantly lower in the prostatectomy group than in the watchful-waiting group:

• Death from prostate cancer: 10% vs. 15%

• All-cause mortality: 27% vs. 32%

• Local progression: 19% vs. 44%

• Distant metastases: 15% vs. 25%

In s…