Prostate cancer death risk won't be cut by radical prostatectomy

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By David Liu, PHD

Friday Aug 10, 2012 (foodconsumer.org) -- Localized prostate cancer patients are better off not taking radical prostatectomy because it does not offer significant death risk reduction while the rate of adverse effects is high, according to a new study in the New England Journal of Medicine.

The study led by Timothy J. Wilt, MD and colleagues found no signficant difference between the death rate among prostate cancer patients who received radical prostatectomy and the rate among those who received observation or oridnary care.

For the study, 731 men aged 67 years on average who were diagnosed with localzied prostate cancer were either given radical prostatectomy or observation from Nov 1994 and Jan 2002 and folowed through Jan 2007.

During the 10-year follow-up, 171 of 364 men (47.0 percent) receiving radical prostatectomy died, compared to  183 of 367 (49.9 percent) assigned abservation.  The absolute reduction in overall death risk was 2.9 percent.

The death rate from prostate cancer or treatment was 5.8 percent among those who received radical prostatectomy, compared to 8.4 percent among those who only received observation. The absolute risk reduction was 2.6 percent.

The effect of treatment on all-cause death risk did not vary with age, race, coexisting conditions, self-reported performance status, and historic features of the tumor.

Death risk was reduced by radical prostatectomy among those whose PSA value was greater than 10 ng per milliliter and possibly also among those with immedtae risk or high risk tumors.

Adverse effects within 30 days after radical prostatectomy were observed in 21.4 percent of patients and one man died after surgery, which means the death risk from surgery was 0.3 percent.

The researchers concluded that radical prostatectomy does not make a signficant reduction in the risk of death from all causes and disease and treatment in prostate cancer patients whose disease was diagnosed with PSA test.

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