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In the PIVOT trial, in which radical prostatectomy was compared with watchful waiting in men with prostate-specific antigen (PSA)-detected, localized prostate cancer (NEJM JW Gen Med Jul 24 2012), mortality was significantly lower with prostatectomy only among those whose PSA levels were >10 ng/mL at the time of diagnosis. Trends toward lower mortality with surgery also were seen in those with high-risk cancers (defined by PSA levels, Gleason scores, and tumor staging). In a newly reported observational study, investigators compared mortality outcomes in more than 34,000 Swedish men with prostate cancer who were treated with radical prostatectomy or radiotherapy (median follow-up, 5.4 years). Patients who were treated with androgen deprivat…