May 17, 2011

PIVOT study: no benefit from radical prostatectomy in low risk early stage prostate cancer

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“What makes the PIVOT study so important is that it is the first randomized trial in the United States to look at radical prostatectomy versus “watchful waiting.”
…
…(Dr. Tim Wilt of the Minneapolis VA medical center concluded) from the data that compared to observation, radical prostatectomy produced:

“reductions in all-cause and prostate cancer mortality that were not significant and less than 3% in absolute terms over 12 years.”

He added that:

“Surgery did not reduce mortality more than observation in men with low PSA or low risk from Prostate Cancer”

However, these “results suggest a benefit from surgery in men with higher PSA or higher risk of disease.”

ADDENDUM on May 18:

I was not at the AUA conference where this presentation was made. But someone who was in the room wrote me:

“I am in Washington at the AUA and you could feel the vacuum in the room when Dr. Wilt presented the data yesterday. In a room filled with urological surgeons, a pall descended.”

ADDENDUM on May 20:

Here’s the webcast of Dr. Wilt’s presentattion to the AUA conference.

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