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Scandinavian Study Shows Radical Prostatectomy Results in Lowered Cancer Death Rate

The New England Journal of Medicine

Abstracted from Associated Press via CNN Interactive

Lars Holmberg et al, New Engl J Med 347, 781, 2002.

CNN/9-12-02---Swedish scientists have demonstrated---for the first time--- that radical prostatectomy reduces the death rate from prostate cancer (CaP). The landmark study, completed between 1989 and 1999, was published in the September 12, 2002 issue of the New England Journal of Medicine. 695 Scandinavian men with localized CaP were randomly assigned to treatment by radical prostatectomy or observation alone. After a median follow-up of 6.2 years, 8.9% of the observed men had died from CaP vs 4.6% of those treated by radical prostatectomy. Relative reduction of risk (CaP death or metastastatic disease) was approximately 50%.

In an accompanying editorial, Patrick C. Walsh of Johns Hopkins University---father of the modern radical prostatectomy---made the following comments:

  • 75% of men in the present study had palpable nodules (Stage T1b), indicating a further advanced disease status than in the U.S, where 75% of men are diagnosed with PSA-detected, non-palpable disease (Stage T1c).
  • Follow-up of only 6.2 years may not be long enough to indicate the true difference between groups, as death risk for CaP is known to continue for as long as 20-25 years after diagnosis.
  • Indirect support for the Holmberg study comes from 2 observations: (1) In the U.S., a sharp decline in CaP mortality has been temporally linked to a dramatic increase in the radical prostatectomy rate. (2) In a 1995 Swedish study, 63% of men with localized CaP living at least 10 years after diagnosis and treated by observation alone ultimately died of their cancer.

Related Links:

Another side of the prostate cancer treatment issue (“The Dilemma”) is told by Gina Kolata in a recent New York Times article

Mortality rates from prostate cancer and other causes are viewed through a different window here

Prostate cancer death rate declining in U.S.

Contemporary Radical Prostatectomy in Step-by-Step Detail


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