This article by Bill-Axelson et al, published in the New England Journal of Medicine, remains one of the most cited articles in the field of urology and is an excellent example of a well conducted RCT – Helping to establish strong evidence around the complex decision making involved in the treatment of men with prostate cancer.
In this trial close to 700 men with early prostate cancer were randomly assigned to either radical prostatectomy or watchful waiting and followed for 10 years. Radical prostatectomy was found to reduce disease-specific mortality, overall mortality, and the risk of metastatic and local progression.
However, selecting the ‘right’ candidate for radical prostatectomy remains a challenging process for both surgeon and patient. The life expectancy and age of the patient, natural history and curability of the cancer, and the morbidity associated with treatment must all be carefully considered.
Read the full article at: https://www.nejm.org/doi/full/10.1056/NEJMoa043739
Bill-Axelson A, et al. Radical prostatectomy versus watchful waiting in early prostate cancer. N Engl J Med 2005;352:1977-84.