RCT | Localized prostate cancer treatment options have similar 15-year survival outcomes

Summary: The study followed 1643 men diagnosed with localized prostate cancer (diagnosed by screening with PSA) in the United Kingdom between 1999 and 2009 who were randomly assigned to receive active monitoring, prostatectomy, or radiotherapy.

After a median follow-up of 15 years, the study found that while prostatectomy and radiotherapy decreased metastasis, local progression, and the need for long-term androgen deprivation therapy, death from prostate cancer was low regardless of the treatment assigned, with 17 deaths (3.1%) in the active-monitoring group, 12 deaths (2.2%) in the prostatectomy group, and 16 (2.9%) deaths in the radiotherapy group (P=0.53). Additionally, the study found that overall deaths were similar between the groups.

The authors suggest that the choice of therapy for localized prostate cancer involves weighing the benefits and harms associated with each treatment option.

Article: Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer – New England Journal of Medicine (link to abstract – $ for full-text)

News Release: Delaying treatment for localised prostate cancer does not increase mortality risk, trial shows – University of Bristol

Commentary on Twitter

Presented at #EAU23: In men with prostate cancer on PSA screening, radical treatments led to half the incidence of metastasis and local progression as active monitoring without affecting disease-specific or overall survival (ProtecT trial) https://t.co/G2ABkMkyJg #oncology pic.twitter.com/s2Va08Fpxj

— NEJM (@NEJM) March 11, 2023