Ten years after a diagnosis of localized prostate cancer, men had a similar risk of dying of the disease regardless of whether they chose surgery, radiation therapy (RT), or active monitoring (AM; also called active surveillance or AS), an exploratory analysis of a multicenter trial showed.
Among 997 patients who chose their own treatment approach, 10-year prostate cancer-specific mortality was 1.85% with AS, 0.67% with surgery, and 0.73% with RT, a difference that did not achieve statistical significance (P=0.08). An exploratory analysis that included treatment-choice cohorts as well as 1,637 randomized patients showed a stronger trend for lower prostate cancer mortality with active treatment (P=0.003).
Men in the AS group also had higher rates of metastasis and disease progression, whereas surgery and RT were associated with more sexual, urinary, and bowel dysfunction, as reported in European Urology.
Collectively, the results "confirmed that surgery and RT reduce metastasis and progression compared with AM, but impact sexual, urinary and bowel functioning," stated David E. Neal, MD, of the University of Oxford in England, and colleagues.
In a patient-directed summary, they emphasized the generally favorable outlook for localized prostate cancer: "More than 95 out of every ...