Surgery reduces risk of death from prostate cancer also in low-risk group

A Swedish research team, partly consisting of researchers from Uppsala University and Karolinska Institutet, followed a group of prostate cancer patients in the Nordic region for 15 years. The study found, among other things, that surgery reduces the risk that men with prostate cancer will die within 15 years - even for those with low-risk tumours. The results were published in the New England Journal of Medicine.

The researchers followed Swedish, Finnish and Icelandic prostate cancer patients, in all 695 men. Radical prostatectomy (surgical removal of the prostate gland) was performed on 347 randomly chosen male patients, while "watchful waiting" (careful monitoring combined with hormone treatment in cases of disease progression) was pursued with respect to 348 others. The men were in average 65 years of age when diagnosed with prostate cancer.

The results of the current study have been analyzed every third year, and have significantly impacted how patients are treated today, both nationally and internationally. The study is the only randomized investigation this far to demonstrate that surgery reduces the risk of mortality from prostate cancer. The majority of the participating men had palpable tumours, and 12 percent had non-palpable tumours that could only be identified using PSA-test.

After 15 years, 16 percent of the men in the prostatectomy group had died due to prostate cancer, against 23 per cent in the watchful-waiting group. The risk of cancer spreading beyond the prostate gland was 12 percent lower for those who received surgery. Analysis on the basis of age groups showed that men younger than 65 benefitted most from surgery.The researchers also studied a group of men with tumours of the least aggressive kind (a low-risk group), even there finding differences in survival rate depending on whether surgery was performed. Source: Karolinska Institute