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Public release date: 14 September 2007
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Surgery for prostate cancer appear to offer greatest survival chance
A study from Switzerland suggests that men who have surgery for prostate cancer appear less likely to die of the disease
within 10 years than men who choose other treatment options, especially if they are younger or have cancers with certain
tumor cell characteristics, according to a report in the Oct. 8 issue of Archives of Internal Medicine.
Prostate cancer treatments are still being debated because they have not yet been compared in a randomized trial, in which
men would be randomly assigned to one treatment or another, according to background information in the article. "Therefore,
treatment choice is strongly influenced by patient and physician personal preferences and experiences," the authors write.
Arnaud Merglen, M.D., of Geneva University, Switzerland, and colleagues used data from the Geneva Cancer Registry to assess
all 844 patients diagnosed with localized (not yet spread) prostate cancer in Geneva between 1989 and 1998. Of those men,
158 received prostatectomy, or surgery to remove all or part of the prostate; 205 had radiation treatment (radiotherapy);
378 chose watchful waiting, which entails active follow-up and treatment if the disease progresses; 72 underwent hormone
therapy; and 31 had another type of therapy.
The average follow-up was 6.7 years (range zero to 15.8 years), and 47 patients (5.6 percent) left Geneva and the study
before the study concluded.
"At 10 years, patients treated with radiotherapy or watchful waiting had a significantly increased risk of death from
prostate cancer compared with patients who underwent prostatectomy," the authors write. Ten-year survival rates from
prostate cancer were 83 percent for prostatectomy, 75 percent for radiotherapy, 72 percent for watchful waiting, 41
percent for hormone therapy and 71 percent for other treatment. "The increased mortality associated with radiotherapy
and watchful waiting was primarily observed in patients younger than 70 years and in patients with poorly differentiated
tumors," or tumors that have certain cellular characteristics and are more likely to spread aggressively.
"Until clinical trials provide conclusive evidence, physicians and patients should be informed of these results and their
limitations," the authors conclude.
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http://archinte.ama-assn.org/
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