TY - JOUR T1 - Radical prostatectomy reduces prostate cancer-specific mortality among men with intermediate-grade disease, but provides minimal benefit for men with low-grade and high-grade disease JF - Evidence Based Medicine JO - Evid Based Med SP - 176 LP - 176 DO - 10.1136/eb-2014-110013 VL - 19 IS - 5 AU - Peter Albertsen Y1 - 2014/10/01 UR - http://ebm.bmj.com/content/19/5/176.abstract N2 - Commentary on: Bill-Axelson A, Holmberg L, Garmo H, et al. Radical prostatectomy or watchful waiting in early prostate cancer. N Eng J Med 2014;370:932–42.OpenUrlCrossRefPubMedWeb of Science As a consequence of testing for prostate-specific antigen (PSA), over 130 000 American men are diagnosed with prostate cancer each year. A significant majority of these men harbour localised disease. The recent update of the Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4) by Bill-Axelson and colleagues provides significant new data that carry important practical implications for contemporary practice. The SPCG-4 was initiated in the 1980s to determine the relative efficacy of radical prostatectomy versus watchful waiting to improve all-cause survival and prostate cancer-specific survival in men with newly diagnosed, localised disease. Between 1989 and 1999 a total of 695 men were randomised to undergo either a radical prostatectomy (n=347) or watchful waiting (n=348). All men received antiandrogen therapy with the onset of disease progression. Men had to be … ER -