Patients with localised prostate cancer have better survival rates after surgery than after radiotherapy, according to an analysis published today.
The conclusions come from a metanalysis published in the journal European Urology.
Experts said the issue needs a major randomised control trial to reach firm conclusions – citing a project planned for Europe next year.
The analysis included 19 studies including some 118,000 patients.
In 15 studies the death rate from prostate cancer was twice as high from radiation as from surgery.
In ten more studies, examining overall mortality, radiation was linked to a 1.5 times higher death rate than surgery.
Researcher Dr Robert Nam, of the University of Toronto, Canada, said: "We have evaluated all the good-quality data comparing surgery and radiotherapy, and the results are pretty conclusive; in general, surgery results in better mortality rates than radiotherapy.
"Nevertheless, there are times when radiotherapy may be more appropriate than surgery, so it is important that a patient discusses treatment options with his clinician."
Professor Nicolas Mottet, from the European Association of Urology, said the findings "deserve attention."
He said: "Definitive proof needs a large well-conducted randomised control trial, such as the upcoming PROTECT trial which is due to report next year. So we certainly need to take this analysis into account, but it doesn’t yet give us a definitive answer as to the best treatment.
"Although this paper should not change clinical practice, I agree with the authors, this analysis gives us important, additional information."
European Urology 15 December 2015 [abstract]
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