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Related Experiment Video

Updated: Aug 7, 2025

A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
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Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer.

Freddie C Hamdy1, Jenny L Donovan1, J Athene Lane1

  • 1From the Nuffield Department of Surgical Sciences, University of Oxford, Oxford (F.C.H., R.J.B., D.E.N.), Population Health Sciences (J.L.D., J.A.L., C.M., M.D., E.L.T., R.M.M., G.J.Y., E.I.W., T.J.P., N.J.W.) and Bristol Trials Centre (J.A.L., C.M., G.J.Y.), Bristol Medical School, University of Bristol, the Department of Urology, Southmead Hospital and Bristol Urological Institute (E.R.), and the Department of Cellular Pathology, North Bristol NHS Trust (J.O.), Bristol, the Department of Urology and Surgery, Western General Hospital, University of Edinburgh, Edinburgh (P.B.), the Department of Urology (A. Doble) and the Division of Urology, Department of Surgery and Cambridge Urology Translational Research and Clinical Trials Office, Cambridge Biomedical Campus (V.G., D.E.N.), Addenbrooke's Hospital, Cambridge, the Department of Urology, Queen Elizabeth Hospital, Birmingham (A. Doherty), the Department of Urology, Cardiff and Vale University Health Board (O.H., H.K.), and the School of Medicine (M.M.) and the Division of Cancer and Genetics (J.S.), Cardiff University, Cardiff, the Department of Urology, University Hospitals of Leicester, Leicester (R.K.), the Department of Urology, Leeds Teaching Hospitals NHS Trust, Leeds (A.P.), the Department of Urology, Freeman Hospital, Newcastle-upon-Tyne (E.P., P.P.), and the Department of Urology, Royal Hallamshire Hospital (D.J.R., J.W.F.C.), and the Academic Urology Unit, Medical School, University of Sheffield (J.W.F.C.), Sheffield - all in the United Kingdom; and the Department of Urological Oncology and Robotic Surgery, Macquarie University, Sydney (D.G.).

The New England Journal of Medicine
|March 13, 2023
PubMed
Summary
This summary is machine-generated.

Prostate cancer mortality was low after 15 years, irrespective of treatment choice. Active monitoring, prostatectomy, and radiotherapy showed similar survival rates for localized prostate cancer patients.

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Area of Science:

  • Urology
  • Oncology
  • Clinical Trials

Background:

  • A large cohort of 82,429 men aged 50-69 in the UK underwent prostate-specific antigen (PSA) testing between 1999-2009.
  • Localized prostate cancer was diagnosed in 2,664 men, with 1,643 enrolled in a treatment evaluation trial.

Purpose of the Study:

  • To compare the effectiveness of active monitoring, prostatectomy, and radiotherapy for localized prostate cancer.
  • To evaluate outcomes including prostate cancer death, all-cause mortality, metastasis, disease progression, and androgen-deprivation therapy initiation.

Main Methods:

  • 1,643 men with localized prostate cancer were randomized into three groups: active monitoring (545), prostatectomy (553), and radiotherapy (545).
  • Outcomes were assessed at a median follow-up of 15 years (range 11-21), with 98% follow-up completion.

Main Results:

  • Prostate cancer-specific mortality was low across all groups (2.7% overall): 3.1% active monitoring, 2.2% prostatectomy, 2.9% radiotherapy (P=0.53).
  • Metastasis and clinical progression rates were significantly lower in the prostatectomy and radiotherapy groups compared to active monitoring.
  • No significant differences in cancer-specific mortality were observed based on baseline risk stratification, PSA level, tumor stage, or grade.

Conclusions:

  • After 15 years, prostate cancer-specific mortality is low regardless of treatment for localized disease.
  • Treatment decisions should balance the benefits and harms of active monitoring, prostatectomy, and radiotherapy.