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A challenge to contemporary management of prostate cancer

Nature Clinical Practice Urology volume 6, pages 12–13 (2009)Cite this article

Abstract

The report by Bill-Axelson et al. challenges current paradigms for diagnosis and treatment of prostate cancer. Contemporary dogma based on 8-year outcomes holds that early diagnosis and treatment improve survival, but after 12 years' follow-up, this study showed no significant difference in overall survival between men randomly allocated radical prostatectomy and those managed with observation. A modest improvement in prostate-cancer-specific survival was only observed in men with a Gleason score of ≥7 who were <65 years of age at diagnosis. After a lead time of 6 years' follow-up, recurrence rates in the radical prostatectomy group were equivalent to those in the observation group. Men diagnosed as having prostate cancer as a result of PSA testing are most likely to benefit from surgery if they have a Gleason score of ≥7 and are aged ≤60 years at diagnosis. Men with a Gleason score of ≤6, especially those >65 years old, are probably best served by active surveillance.

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Author notes

  1. University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-3955, USA albertsen@nso.uchc.edu

Authors and Affiliations

  1. PC Albertsen is Professor and Chief of Urology at the University of Connecticut Health Center, CT, USA.,

    Peter C Albertsen

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  1. Peter C Albertsen
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The author declares no competing financial interests.

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Albertsen, P. A challenge to contemporary management of prostate cancer. Nat Rev Urol 6, 12–13 (2009). https://doi.org/10.1038/ncpuro1270

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