Re: Delayed Treatments for Prostate Cancer


New data in this month:

13 year outcomes study results are in. Isn't this the kind of stuff YOU are
looking for, George? It showed that for low, intermediate, and high risk
prostate cancers, there was a significant survival advantage for radical
prostatectomy over active surveillance, even after adjusting for age,
pathology, etc. on multivariate analysis. These are results from Dr.
Albertsen of UConn and based on the results of the Connecticut Tumor
Registry. A nice feature of this study is that every patient's slides
(almost 2,000) were reviewed by a single pathologist. This is important
nowadays since there has been a "stage migration" of prostate cancer over
the last decade or so.

They had great followup with 75% of patients having more than 12.8 years of
followup. At this timepoint, they found that "mortality rates were 2.5 and
3.2 times higher for radiation therapy and observation, respectively,
compared with surgery across all of the categories".

These results are in the August issue of the AUA News, a monthly
publication.

This is more supportive evidence that surgery not only greatly improves
survival (3 fold increased risk of death without surgery is a huge change)
but also is equally efficacious for those with low grade low volume disease
as it is with men with high grade high volume disease (excluding those with
metastatic disease of course).

There is some "real world" outcomes data for ya buddy.


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