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One of the challenges in measuring the benefit of curative-intent local therapy for prostate cancer is the relative dearth of randomized clinical trials with long-term follow-up data. To address this issue, Scandinavian investigators conducted a prospective, randomized study in which 695 European men with localized disease were assigned to undergo radical prostatectomy or watchful waiting and followed for an average of 23 years (maximum, 29 years). Patients were <75 years of age and had anticipated life expectancy of >10 years, prostate-specific antigen (PSA) values <50 ng/mL, highly or moderately highly differentiated tumor pathology (WHO classification), and evidence of clinically localized disease.
During the 29 years since the study bega…