Surgery vs. Observation for Early-Stage Prostate Cancer

In a prior trial of 695 men with localized prostate cancer, investigators from the Scandinavian Prostate Cancer Group Study Number 4 showed that, during median follow-up of 10.8 years, patients randomized to radical prostatectomy had lower risk for mortality and metastases than those assigned to observation (JW Oncol Hematol Sep 16 2008). In that study, patients in the surgery group with local recurrence (palpable or histologically confirmed) received hormonal therapy. Those in the observation group with obstructive voiding disorders received transurethral resection, and those with metastases detected by bone scan received hormonal therapy.

Now, these investigators report that, after a median follow-up of 12.8 years, mortality was lower in t…