HealthDay News — Surgical treatment reduces long-term mortality among men with localized prostate cancer compared with those who undergo watchful waiting, according to research published the New England Journal of Medicine.

Anna Bill-Axelson, MD, PhD, of the Uppsala University Hospital in Sweden, and colleagues randomly assigned 695 men with early prostate cancer to either radical prostatectomy or watchful waiting.

The researchers found that, at approximately 23 years of follow-up, patients who received surgery were significantly less likely to have died than those who underwent watchful waiting (relative risk 0.56; 95% CI: 0.41 to 0.77; P=0.001).

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The number needed to treat to prevent one death was eight. The mortality benefit associated with surgery for localized prostate cancer was greatest in men younger than age 65 years (RR 0.45) and in those with intermediate-risk disease (RR 0.38). Among older men, radical prostatectomy was associated with a decreased risk of metastases (RR 0.68; P=0.04).

“Extended follow-up confirmed a substantial reduction in mortality after radical prostatectomy; the number needed to treat to prevent one death continued to decrease when the treatment was modified according to age at diagnosis and tumor risk,” the authors write.


  1. Bill-Axelson A et al. N Engl J Med. 2014; doi:10.1056/NEJMoa1311593.