Results The AUA ( American Urological Association ) , ASTRO , and SUO ( Society of Urologic Oncology ) formulated an evidence ‐based guideline based on a risk stratified clinical framework for the management of localized prostate cancer .
Purpose This guideline is structured to provide a clinical framework stratified by cancer severity to facilitate care decisions and guide the specifics of implementing the selected management options .
The summary presented represents Part I of the two‐part series dedicated to Clinical ly Localized Prostate Cancer : AUA/ASTRO/SUO Guideline discussing risk stratification and care options by cancer severity .
Mortality after radical prostatectomy or external beam radiotherapy for localized prostate cancer.
BACKGROUND No r and omized trials have compared survival outcomes for men with localized prostate cancer ( PC ) being treated with radical prostatectomy ( RP ) or external beam radiotherapy ( EBRT ) . The goal of the study , therefore , was to estimate the association of RP ( compared with EBRT ) with overall and PC mortality . METHODS We analyzed an observational cohort from the population -based Prostate Cancer Outcomes Study , which included men aged 55 to 74 years diagnosed with localized PC between October 1994 and October 1995 who underwent either RP ( n = 1164 ) or EBRT ( n = 491 ) within 1 year of diagnosis . Patients were followed until death or study end ( December 31 , 2010 ) . Overall and disease-specific mortality were assessed with multivariable survival analysis , with propensity scores to adjust for potential treatment selection confounders ( demographics , comorbidities , and tumor characteristics ) . All statistical tests were two-sided . RESULTS After 15 years of follow-up , there were 568 deaths , including 104 from PC . RP was associated with statistically significant advantages for overall ( hazard ratio [ HR ] = 0.60 , 95 % confidence interval [ CI ] = 0.53 to 0.70 , P < .0001 . ) and disease-specific mortality ( HR = 0.35 , 95 % CI = 0.26 to 0.49 , P < .0001 . ) . Mortality benefits for RP were also observed within treatment propensity quintiles , when subjects were pair-matched on propensity scores , and in subgroup analyses based on age , tumor characteristics , and comorbidity . CONCLUSIONS Population -based observational data on men diagnosed with localized PC in the mid-1990s suggest a mortality benefit associated with RP vs EBRT . Possible explanations include residual selection bias or a true survival advantage . Results might be less applicable for men facing treatment decisions today
Results The AUA ( American Urological Association ) , ASTRO , and SUO ( Society of Urologic Oncology ) formulated an evidence ‐based guideline based on a risk stratified clinical framework for the management of localized prostate cancer .
Purpose This guideline is structured to provide a clinical framework stratified by cancer severity to facilitate care decisions and guide the specifics of implementing the selected management options .
The summary presented represents Part I of the two‐part series dedicated to Clinical ly Localized Prostate Cancer : AUA/ASTRO/SUO Guideline discussing risk stratification and care options by cancer severity .