Scandinavian Study Shows Radical Prostatectomy Results
in Lowered Cancer Death Rate
Abstracted from Associated Press via CNN Interactive
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
- 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.
side of the prostate cancer treatment issue (“The Dilemma”)
is told by Gina Kolata in a recent New York Times article
rates from prostate cancer and other causes are viewed through a different
cancer death rate declining in U.S.
Radical Prostatectomy in Step-by-Step Detail