ㅤTake-home message from Bill-Axelson A. 2018, published in The New England Journal of Medicine):
Men with clinically detected, localized prostate cancer and a long-life expectancy benefit from radical prostatectomy, with an estimate of 2.9 years of life gained.
Prostate cancer with extracapsular extension carries a 5-time higher risk of death compared to cancer specimens without extracapsular extension.
Prostate cancer with a Gleason score higher than 7 carries a 10-time higher risk of death compared to prostate cancer Gleason score 6 or lower.
ㅤTake-home message from Hamdy 2016, published in NEJM):
This study compared the effectiveness of active monitoring, surgery or radiotherapy in patients diagnosed with localised prostate cancer. At 10-years, they found that there was no significant difference in the rates of death between the groups, but found that there was a greater rate of metastases and disease progression in the active monitoring group, when compared to surgery or radiotherapy.
ㅤTake-home message from Wilt 2017, published in New England Journal of Medicine):
This randomised controlled trial included approximately 700 patients with localised prostate cancer; patients were assigned to surgery (radical prostatectomy) or observation and followed up for a median of 12.7 years. There was no significant difference in all-cause mortality or prostate cancer related mortality; surgery led to a 5.5% absolute reduction in all-cause mortality and 4.0% absolute reduction in prostate cancer mortality.
ㅤTake-home message from Bolla 2002, published in The Lancet):
In patients with locally advanced prostate cancer, androgen suppression (with LHRH analogues) during and after external radiation therapy for 3 years, improves patient outcomes
Disease free period improved from 40% to 74%
Overall survival improved from 62% to 78%
ㅤTake-home message from Christopher C Parker 2020, published in Lancet):
These initial results do not support routine administration of adjuvant radiotherapy after radical prostatectomy. Adjuvant radiotherapy increases the risk of urinary morbidity. An observation policy with salvage radiotherapy for PSA biochemical progression should be the current standard after radical prostatectomy.
ㅤTake-home message from Freedland 2023, published in The New England Journal of Medicine:
Enzalutamide monotherapy or in combination with leuprolide may improve 5-year metastasis-free survival compared to leuprolide alone in adults with prostate cancer with high-risk biochemical recurrence after definitive radical prostatectomy or radiation therapy.