Follow-up of Prostatectomy versus Observation for Early Prostate Cancer

Published on Jul 13, 2017in The New England Journal of Medicine70.67
· DOI :10.1056/NEJMoa1615869
J Wilt78
Estimated H-index: 78
Karen M. Jones11
Estimated H-index: 11
+ 5 AuthorsMichael K. Brawer5
Estimated H-index: 5
(Myriad Genetics)
BackgroundWe previously found no significant differences in mortality between men who underwent surgery for localized prostate cancer and those who were treated with observation only. Uncertainty persists regarding nonfatal health outcomes and long-term mortality. MethodsFrom November 1994 through January 2002, we randomly assigned 731 men with localized prostate cancer to radical prostatectomy or observation. We extended follow-up through August 2014 for our primary outcome, all-cause mortality, and the main secondary outcome, prostate-cancer mortality. We describe disease progression, treatments received, and patient-reported outcomes through January 2010 (original follow-up). ResultsDuring 19.5 years of follow-up (median, 12.7 years), death occurred in 223 of 364 men (61.3%) assigned to surgery and in 245 of 367 (66.8%) assigned to observation (absolute difference in risk, 5.5 percentage points; 95% confidence interval [CI], −1.5 to 12.4; hazard ratio, 0.84; 95% CI, 0.70 to 1.01; P=0.06). Death attribu...
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