Allan V. Prochazka, MD, MSc; Tanner J. Caverly, MD
What are the long-term relative effects of radical prostatectomy and watchful waiting on quality of life in men with localized prostate cancer?
Randomized controlled trial (Scandinavian Prostate Cancer Group Study Number 4 [SPCG-4]).
Median 12.2 years (range 7 to 17 y).
Sweden and Finland.
695 men < 75 years of age with clinically localized prostate cancer and life expectancy > 10 years. 291 men died, and 4 men from Iceland were excluded; the remaining 400 men (mean age 77 y) were eligible for the quality-of-life study.
Radical prostatectomy (n = 208) or watchful waiting (n = 192).
Included quality of life, depressed mood, anxiety, erectile dysfunction, daytime urine leakage, nighttime urine leakage, and weak urine stream. All outcomes were based on responses to a mailed questionnaire.
349 of 400 surviving men (87%) (intention-to-treat analysis).
Radical prostatectomy and watchful waiting did not differ for self-assessed quality of life, depressed mood, anxiety, or erectile dysfunction; radical prostatectomy was associated with a higher rate of daytime and nighttime urine leakage but a lower rate of weak urine stream than was watchful waiting (Table).
In men with localized prostate cancer, radical prostatectomy and watchful waiting did not differ for quality of life at a median 12.2 years.
Radical prostatectomy (RP) vs watchful waiting (WW) in men with localized prostate cancer‡
‡NS = not significant; RBR = relative benefit reduction; other abbreviations defined in Glossary. RBR, RRR, RRI, NNT, NNH, and CI calculated from relative risks and control event rates in article.
||RBR estimate is not in the expected direction probably because of adjustment for age.
Prochazka AV, Caverly TJ. Radical prostatectomy and watchful waiting for localized prostate cancer did not differ for quality of life. Ann Intern Med. 2012;156:JC4–3. doi: 10.7326/0003-4819-156-8-201204170-02003
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Published: Ann Intern Med. 2012;156(8):JC4-3.
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