Surgery seen best for localized prostate cancer

NEW YORK (Reuters Health) - Both surgery (radical prostatectomy) and radiation therapy result in significantly higher survival rates in men with prostate cancer that hasn't spread beyond the gland, compared with less definitive approaches, according to the results of a large study conducted at the Henry Ford Health System in Detroit.

Dr. Ashutosh Tewari, of New York-Presbyterian Hospital-Weill Cornell Medical Center in New York City, and colleagues studied 3,159 men, 75 years of age or younger, with biopsy-confirmed, localized prostate cancer, treated between 1980 and 1997.

"A patient was considered to have undergone radiotherapy or prostatectomy if he received that treatment within 6 months of diagnosis; otherwise, he was assigned to 'conservative management'," the researchers explain in the medical journal Urology.

The overall survival rate at 15 years after treatment was 35 percent with conservative management, 50 percent with radiation treatment and 65 percent with radical prostatectomy, the team reports.

When deaths due specifically to prostate cancer were considered, survival rates were 79 percent, 87 percent and 92 percent with conservative management, radiation and surgery, respectively.

Looked at another way, men who had radiation treatment lived an average of 4.6 years longer with radiotherapy, and 8.6 years longer with radical prostatectomy, than those managed conservatively.

Because this was a look-back study, Tewari and colleagues caution that forward-looking clinical trials are still needed to compare the survival benefits of each of these three treatment approaches.

SOURCE: Urology, December 2006.