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Determining a management strategy for men with low-risk, clinically localized prostate cancer identified by prostate-specific antigen (PSA) testing remains a challenge given the paucity of data. To compare three initial approaches for such patients, U.K. investigators randomized 1643 men (median age, 62 years) with localized disease (median PSA, 4.6 ng/mL) to active monitoring (regular PSA testing and curative or palliative intervention with progression), radical prostatectomy, or radiotherapy (3–6 months of androgen-deprivation therapy and 74 Gy).
Of these patients, 76% had clinical stage-T1c disease, and 77% had tumors with a Gleason score of 6. More than 70% of patients received the specified management within 9 months of randomization. O…