Cancer-related mortality remains low long after radical surgery

In the 15 years following a radical prostatectomy, there is only a 12% mortality rate directly connected to prostate cancer, regardless of the cancer’s aggressiveness, according to a multicenter study appearing in the Journal of Clinical Oncology online. Comparatively, there was a 38% rate of non-cancer-related death in this same group of patients.

A team of researchers at Memorial Sloan-Kettering Cancer Center, New York; Cleveland Clinic; and the University of Michigan, Ann Arbor, worked together on the first large-scale, multi-institutional study of prostate cancer death following conventional radical prostatectomy. The team has developed or validated statistical models to help forecast the natural progression of prostate cancer and its expected response to treatment, enabling clinicians to customize treatment for their patients.

The study tracked 12,677 men who underwent radical prostatectomy between 1987 and 2005. Of these, 6,398 underwent radical prostatectomy for localized prostate cancer at Sloan-Kettering or Baylor College of Medicine, Houston; 809 (13%) received neoadjuvant androgen deprivation therapy for an average of 3.2 months. External nomogram validation was conducted on 4,103 patients treated at Cleveland Clinic and 2,176 patients treated at University of Michigan during this period.

Pathologists reviewed prostate biopsy specimens at each institution prior to surgery. Patients were followed with PSA tests and clinical exams at 3- and 6-month intervals for 5 years, then annually thereafter.

Results showed just 4% of those treated surgically within the past 10 years had a 5% or greater risk of dying of prostate cancer within 15 years.

"The importance of this paper is that it shows a remarkably low risk of dying of prostate cancer within 15 years for treated men, and supports the concept that men with slow-growing cancers may not need immediate treatment," said senior author Peter Scardino, MD, of Sloan-Kettering.