UK Study Focuses on Outcomes by Therapy After 15 Years of Follow-up

By: Joshua Swore, PhD
Posted: Friday, April 7, 2023

Mortality from prostate cancer remained low in patients regardless of the therapeutic approach used to manage their disease, according to a study published in The New England Journal of Medicine. The 15-year follow-up data from the ProtecT Study Group were based on more than 1,600 patients treated with prostate cancer in the United Kingdom. These findings suggest that the therapeutic modality of choice should be selected as determined by the associated benefits and risks, explained F.C. Hamdy, FRCS, of the University of Edinburgh, and colleagues.

Clinicians may avoid overtreatment by ensuring that men with newly diagnosed, localized prostate cancer consider critical trade-offs between short-term and long-term effects of treatments on urinary, bowel, and sexual function, as well as the risks of [disease] progression, as stated in a press release from the European Society for Medical Oncology.

From 1999 to 2009, a total of 1,643 men with localized prostate carcinoma were recruited for the study. Patients were stratified based on the therapeutic intervention they received including active monitoring (n = 545), prostatectomy (n = 553), or radiotherapy (n = 545). Patients subsequently returned for follow-up at a median of 15 years after receiving treatment, and follow-up was complete for 98% of patients.

The study findings revealed that 2.7% of the patients died of their disease. Of these patients, 12 had received prostatectomy, 16 had received radiotherapy, and 17 were being actively monitored. In addition, 4.7%, 5.0%, and 9.4% of patients developed metastases in the prostatectomy, radiotherapy, and active monitoring groups, respectively. Moreover, androgen-deprivation therapy was required in 7.2% of men who received prostatectomy, 7.7% of men who received radiotherapy, and 12.7% of men in the active monitoring group. Furthermore, 24.4% of men who were being actively monitored were alive without ever receiving any additional intervention for their prostate cancer.

Disclosure: For full disclosures of study authors, visit nejm.org.

The New England Journal of Medicine

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