Patients with localized prostate cancer who undergo surgery are less likely to die from the disease within ten years than patients who choose other treatments, especially if they are younger or have tumors with certain cell characteristics, according to an article in the October 8 issue of Archives of Internal Medicine.

Prostate cancer treatments are still being debated because they have not yet been compared in a randomized trial, in which men would be randomly assigned to one treatment or another, according to background information in the article. “Therefore, treatment choice is strongly influenced by patient and physician personal preferences and experiences,” the authors wrote.

Arnaud Merglen, MD, of Geneva University, Switzerland, and colleagues used data from the Geneva Cancer Registry to assess all 844 patients diagnosed with localized prostate cancer in Geneva between 1989 and 1998. Of those men, 158 underwent prostatectomy, 205 had radiotherapy, 378 chose watchful waiting, 72 received hormone therapy, and 31 had another type of therapy.

The average follow-up was 6.7 years (range, zero to 15.8 years), and 47 patients (5.6 percent) left the area before the study concluded.

“At 10 years, patients treated with radiotherapy or watchful waiting had a significantly increased risk of death from prostate cancer compared with patients who underwent prostatectomy,” the authors wrote.

Ten-year survival rates from prostate cancer were 83 percent for prostatectomy, 75 percent for radiotherapy, 72 percent for watchful waiting, 41 percent for hormone therapy and 71 percent for other treatment.

“The increased mortality associated with radiotherapy and watchful waiting was primarily observed in patients younger than 70 years and in patients with poorly differentiated tumors. Until clinical trials provide conclusive evidence, physicians and patients should be informed of these results and their limitations,” the authors concluded.