The role of radical prostatectomy in patients with prostate cancer
Even in the presence of screening, there is benefit to radical prostatectomy (RP) in prostate cancer patients, however, the benefit is limited to a subgroup of patients and can take years to become evident according to a study published February 14 in the Journal of the National Cancer Institute.
The Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4) trial identified that RP lowered prostate cancer deaths with a statistically significant absolute mortality difference (AMD) between RP and watchful waiting (WW) of 6.1%. The Prostate Cancer Intervention Versus Observation Trail (PIVOT) recently published results from a US-based trial comparing the effectiveness of RP compared with watchful waiting (WW). The PIVOT trial found a non-statistically significant reduction in the risk of prostate cancer death in the RP group with an absolute risk reduction of 3% after a 12-year follow-up. Although these findings may seem inconsistent with the results from the Scandinavian trial, it is unknown if more frequent screen detection in PIVOT can explain the lower AMD.
In order to determine if a more frequent screen detection in PIVOT explains the lower AMD when compared to the SPCG-4 trial, Jing Xia, Ph.D., of the Fred Hutchinson Cancer Research Center in Seattle and colleagues, assumed that the SPCG-4 trial represented RP efficacy and prostate cancer survival in an unscreened population. They then adjusted prostate cancer survival using published estimates of overdiagnosis and lead time to evaluate the effect of screen detection on disease-specific deaths and the observed AMD.
The researchers found that overdiagnosis and lead time explains the lower AMD in PIVOT if the RP efficacy and prostate cancer survival in the absence of screening are comparable to that of the SPCG-4 trial. They conclude that if these findings are the correct explanation, then a specific set of cases should not be treated with RP and that their identification should lead to a better understanding of the RP benefit in the remaining cases. "PIVOT should not be interpreted as evidence that RP is not efficacious in reducing prostate cancer mortality," the researchers write. "PIVOT should encourage us to develop tests to identify cases for which immediate treatment is beneficial."
More information: DOI:10.1093/jnci/djt017
Journal reference:
Journal of the National Cancer Institute
Provided by
Journal of the National Cancer Institute
-
Changes in penile length after radical prostatectomy studied
Dec 16, 2012 |
not rated yet |
0
-
Prostatectomy improves outcome of some men with prostate cancer over watchful waiting
Aug 12, 2008 |
not rated yet |
0
-
Prostate cancer surgery better at teaching hospitals
Nov 07, 2011 |
not rated yet |
0
-
Surgery reduces risk of mortality due to prostate cancer even for low-risk groups
May 05, 2011 |
not rated yet |
0
-
High pretreatment PSA velocity predicts worse outcome
May 25, 2007 |
not rated yet |
0
-
Motion perception revisited: High Phi effect challenges established motion perception assumptions
Apr 23, 2013 |
3 / 5 (2) |
2
-
Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update)
Apr 02, 2013 |
4.5 / 5 (11) |
5
-
The visual system as economist: Neural resource allocation in visual adaptation
Mar 30, 2013 |
5 / 5 (2) |
9
-
Separate lives: Neuronal and organismal lifespans decoupled
Mar 27, 2013 |
4.9 / 5 (8) |
0
-
Sizing things up: The evolutionary neurobiology of scale invariance
Feb 28, 2013 |
4.8 / 5 (10) |
14
-
Pressure-volume curve: Elastic Recoil Pressure don't make sense
23 hours ago
-
If you became brain-dead, would you want them to pull the plug?
May 17, 2013
-
MRI bill question
May 15, 2013
-
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013
-
Alcohol and acetaminophen
May 13, 2013
-
Marie Curie's leukemia
May 13, 2013
- More from Physics Forums - Medical Sciences
More news stories
New smartphone application improves colonoscopy preparation
The use of a smartphone application significantly improves patients' preparation for a colonoscopy, according to new research presented today at Digestive Disease Week (DDW). The preparation process, which begins days in ...
Cancer
1 hour ago |
not rated yet |
0
Research examines new methods for managing digestive health
Research presented at Digestive Disease Week (DDW) explores new methods for managing digestive health through diet and lifestyle.
Cancer
2 hours ago |
not rated yet |
0
New colonoscope provides ground-breaking view of colon
A ground-breaking advance in colonoscopy technology signals the future of colorectal care, according to research presented today at Digestive Disease Week(DDW). Additional research focuses on optimizing the minimal withdrawal ...
Cancer
17 hours ago |
5 / 5 (2) |
0
ASCO: combo antibody therapy effective for melanoma
(HealthDay)—Concurrent use of two immune checkpoint antibodies—ipilimumab and nivolumab—may be effective for the treatment of advanced melanoma, according to a proof-of-principal study presented in ...
Cancer
May 17, 2013 |
not rated yet |
0
Risk factors ID'd for poor cutaneous cell CA outcomes
(HealthDay)—The risks of metastasis and death associated with cutaneous squamous cell carcinoma (CSCC) are low, but significant, and risk factors for poor outcome include tumor diameter, invasion beyond ...
Cancer
May 17, 2013 |
not rated yet |
0
|
Ketamine shows significant therapeutic benefit in people with treatment-resistant depression
Patients with treatment-resistant major depression saw dramatic improvement in their illness after treatment with ketamine, an anesthetic, according to the largest ketamine clinical trial to-date led by researchers from the ...
Consuming coffee linked to lower risk of detrimental liver disease, study finds
Regular consumption of coffee is associated with a reduced risk of primary sclerosing cholangitis (PSC), an autoimmune liver disease, Mayo Clinic research shows. The findings were being presented at the Digestive Disease ...
New research identifies practice changes to improve value and quality of GI procedures
There are significant cost and risk factors associated with two procedures commonly used to diagnose or treat gastrointestinal problems, according to research presented at Digestive Disease Week (DDW).
New research identifies risks, interventions for children's GI health
An increasing number of U.S. children are experiencing gastrointestinal issues that require interventions to resolve, according to research presented at Digestive Disease Week (DDW).
US psychiatry gets makeover in new manual
The latest makeover to a massive psychiatric tome honored by some, reviled by others and even called the "Bible" of mental disorders is being released Saturday with a host of new changes.
New case of SARS-like virus in Saudi: ministry
A new case of the deadly coronavirus has been detected in Saudi Arabia where 15 people have already died after contracting it, the health ministry announced on Saturday on its Internet website.
