Definitive therapy better than observation for men with localized prostate Ca

Definitive therapy appears to improve survival in men with early-stage prostate cancer, researchers from the University of Utah, Salt Lake City, reported. The magnitude of the benefit on prostate cancer-specific mortality or any-cause mortality was similar for both brachytherapy and surgery, regardless of patient age.

In all, 60,290 men diagnosed with organ-confined, low- and moderate-grade prostate cancer between 1988 and 2002 were retrospectively identified from centers participating in the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Prostate cancer-specific mortality and any-cause mortality were determined. Outcomes for patients treated by brachytherapy, surgery, or those who received no definitive treatment were compared using the Wilcoxon test, stratified by T-stage and grade, and using multivariate analysis (Cancer 2006; 107:2392-400).

Median follow-up time was 46 months (range, 0-189 months). For men under age 60 years at diagnosis, prostate cancer-specific mortality at 10 years was 1.3%, 0.5%, and 3.7% for surgery, brachytherapy, and no definitive therapy, respectively. For men 60 years of age and older, the prostate cancer-specific mortality was 3.8%, 5.3%, and 8.4%, respectively.

On univariate and multivariate analysis, surgery and brachytherapy resulted in statistically equivalent prostate cancer-specific mortality and any-cause mortality, and both had a significantly lower prostate cancer-specific mortality and any-cause mortality versus no definitive therapy, according to the study’s authors.