Journal WatchRadical Prostatectomy Trumps Watchful Waiting in Early Prostate Cancer Commentary on: Radical Prostatectomy or Watchful Waiting in Early Prostate Cancer
Section snippets
Summary
This is the latest update of the Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4). Between 1989 and 1999, we randomly assigned 695 men with early prostate cancer (PCa) to watchful waiting (WW) or radical prostatectomy (RRP) and followed through the end of 2012. This cohort was enrolled before the institution of prostate-specific antigen (PSA) screening, and WW was not performed according to a specific protocol as active surveillance currently is done. The study looked not only at
Comment
This update of the SPCG-4 trial contains many important points that help to define what impact we are having by treating our PCa patients with RRP. The extended follow-up with the increased number of events allows the authors to perform more meaningful subgroup analyses. This study offers further perspective on the Prostate Cancer Intervention versus Observation Trial (PIVOT) trial, which randomized 731 men with screen-detected cancer to active surveillance or RRP,2 and it has implications for
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Cited by (2)
Primary Radical Prostatectomy or Ablative Radiotherapy as Protective Factors for Patients With mCRPC Treated With Radium-223 Dichloride: An Italian Multicenter Study
2020, Clinical Genitourinary CancerCitation Excerpt :At present, RP is a therapeutic option that can be proposed to selected patients who are strongly motivated to undergo an invasive treatment that often requires complementary therapies, such as EBRT and ADT, with an adequate life expectancy and the absence of important comorbidities and contraindications to the surgical procedure. The efficacy of surgical treatment has been demonstrated in both observational studies and prospective studies compared with watchful waiting.24,32 Surgical therapy has proven advantages in terms of OS, cancer-specific mortality, and a reduction in the risk of local progression and distant spread.
Bill-Axelson A, Holmberg L, Garmo H, et al.
N Engl J Med 2014 Mar 6;370(10):932-42. http://dx.doi.org/10.1056/NEJMoa1311593.