Surgery offers better long-term prostate Ca survival than other options

Men who have prostate cancer surgery, especially if they are younger or have cancers with certain tumor cell characteristics, appear less likely to die of the disease within 10 years than are men who choose other treatment options, according to a report in Archives of Internal Medicine (2007; 167:1944-50).

Arnaud Merglen, MD, of Geneva University, Switzerland, and colleagues used data from the Geneva Cancer Registry to assess all 844 patients diagnosed with localized prostate cancer in Geneva between 1989 and 1998. Of those men, 158 received prostatectomy, 205 had radiation treatment, 378 chose watchful waiting, 72 underwent hormone therapy, and 31 had another type of therapy. The average follow-up was 6.7 years, and 47 patients (5.6%) left Geneva before the study concluded.

“At 10 years, patients treated with radiotherapy or watchful waiting had a significantly increased risk of death from prostate cancer compared with patients who underwent prostatectomy,” the authors wrote.

Ten-year survival rates from prostate cancer were 83% for prostatectomy, 75% for radiotherapy, 72% for watchful waiting, 41% for hormone therapy, and 71% for other treatment.

“The increased mortality associated with radiotherapy and watchful waiting was primarily observed in patients younger than 70 years and in patients with poorly differentiated tumors,” the authors wrote. “Until clinical trials provide conclusive evidence, physicians and patients should be informed of these results and their limitations.”