Prostate Cancer and the John West Effect.

EAU-ESTRO-ESUR-SIOG Prostate Cancer Guidelines Panel · Eur Urol · 2017

editorial · Level V

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Abstract

The first results of the UK ProtecT study have been published. A total of 1643 men with localised prostate cancer were randomised between active monitoring, radical prostatectomy, and external-beam radiotherapy. Comparisons between treatments showed no differences between surgery and radiotherapy in terms of cancer-specific survival and overall survival. Moreover, the patient-reported outcomes indicate that although the patterns of treatment-related side effects differ markedly according to the modality, neither surgery nor radiotherapy appears to be "kinder" overall. Conclusions from nonrandomised case series can be misleading, however carefully they are analysed, and this is particularly so for early prostate cancer.

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