Radical prostatectomy (RP) for localized prostate cancer (PCa) is associated with the lowest risk of dying from the malignancy compared with other management approaches, according to study findings presented at the 34th Annual European Association of Urology Congress in Barcelona, Spain.

In a study of 11,719 men with localized PCa by Annika Herlemann, MD, and colleagues at the University of California, San Francisco, 493 (4%) died from PCa during an 18-year follow-up period. The median time to PCa-specific mortality (PCSM) was 85 months.

Compared with RP, brachytherapy, external beam radiation therapy, primary androgen deprivation therapy, and active surveillance/watchful waiting were associated with significant 1.5-, 1.8-, 2.8-, and 1.8-fold increased risks of PCSM, respectively, after adjusting for CAPRA (Cancer of the Prostate Risk Assessment) score, age, and case-mix.

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Dr Herlemann’s group found the greatest difference in PCSM risk between RP and the other treatment approaches among patients with high-risk disease. No treatment approach showed a significant PCSM benefit among patients with low-risk disease.

The men in the study were participants in CaPSURE (Cancer of the Prostate Strategic Urologic Research Endeavor), a longitudinal, observational study that includes more than 15,000 men with PCa managed at 43 mostly community-based US clinical practice sites.


Herlemann A, Cowan JE, Washington SL III, et al. 18-year prostate cancer-specific mortality after prostatectomy, brachytherapy, external beam radiation therapy, hormonal therapy, or monitoring for localized prostate cancer. Presented at the 34th Annual European Association of Urology Congress in Barcelona, Spain, March 15-19. Abstract 213.