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Evolving evidence from randomized trials assessing the utility of surgery versus surveillance for localized prostate cancer has provided mixed results. Among the studies suggesting no benefit from prostatectomy is the randomized PIVOT study (N Engl J Med 2012 Jul 19; 367:203), which showed that among 731 men with localized disease, radical prostatectomy did not significantly reduce all-cause or prostate cancer mortality, as compared with observation, through a median of 10.0 years of follow-up. Now, the PIVOT investigators have updated these results through a median of 12.7 years and a maximum of 19.5 years of follow-up.
A total of 64% of the men died from any cause, and the 19.5-year cumulative incidence of death from any cause was similar …