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The Scandinavian Prostate Cancer Group-4 trial is the only contemporary randomized trial in which radical prostatectomy and watchful waiting have been compared in patients with localized prostate cancer. Most patients in this trial had palpable cancers; only 12% were detected by high prostate-specific antigen (PSA) levels. When initial results were published (median follow-up, 6 years), prostate cancer–specific mortality — but not overall mortality — was lower in the surgery group (JW Sep 20 2002). In an update that was published after a median follow-up of 8 years, both prostate-specific and overall mortality were lower in the prostatectomy group than in the control group (JW May 20 2005).
Now, the researchers present additional follow-up: …