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For several decades, the “10-year survival rule” has guided urologists and radiation oncologists in making therapy recommendations to older men with clinical evidence of organ-confined prostate cancer. Findings from a randomized Scandinavian trial in which radical prostatectomy was compared with observation demonstrated a survival benefit from surgery; however, this advantage was seen primarily in patients younger than 65 (Journal Watch May 20 2005). Older men with substantial comorbidities often receive either expectant management or androgen-deprivation therapy.
In an observational study using data from the Surveillance, Epidemiology, and End Results (SEER) and Medicare databases, researchers evaluated a cohort of more than 44,000 older me…