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Radical prostatectomy reduced death and progression more than watchful waiting in early prostate cancer

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 Q In men with early prostate cancer, how do radical prostatectomy (RP) and watchful waiting (WW) compare?

Clinical impact ratings GP/FP/Primary care ★★★★★★★ IM/Ambulatory care ★★★★★★☆ Surgery—urology ★★★★★★☆ Oncology ★★★★★★☆ Nephrology ★★★★★★☆


Embedded ImageDesign:

randomised controlled trial (Scandinavian Prostate Cancer Group Study Number 4).

Embedded ImageAllocation:


Embedded ImageBlinding:

blinded {outcome assessors, data safety and monitoring committee, and data analysts}.*

Embedded ImageFollow-up period:

mean 8.5–8.8 years (median 8.2 y).

Embedded ImageSetting:

14 centres in Sweden, Finland, and Iceland.

Embedded ImagePatients:

695 men <75 years of age (mean age 65 y) with newly diagnosed, untreated, localised prostate cancer; tumour stage T0d (later changed to T1b), T1, or T2; life expectancy >10 years; prostate specific antigen (PSA) level <50 ng/ml; and no abnormalities on bone scan.

Embedded ImageIntervention:

RP (n = 347) or WW (n = 348).

Embedded ImageOutcomes:

death from prostate cancer, distant metastasis, local progression, and death from any cause.

Embedded ImagePatient follow up:

100% (intention to treat analysis).


Fewer patients …

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