Prostate cancer surgery may offer "negligible" benefits to many men with early-stage, a 20-year U.S. study said Wednesday.
In such men, who account for most cases of newly diagnosed prostate cancer, surgery did not prolong life and often caused serious complications such as infection, urinary incontinence and erectile dysfunction, according to the study published in The New England Journal of Medicine.
"This study confirms that aggressive treatment usually is not necessary," co-author Gerald Andriole, director of Washington University's Division of Urologic Surgery, said in a statement.
"We hope the findings will steer doctors away from recommending surgery or radiation to their patients with nonaggressive early-stage prostate cancer and patients away from thinking it's necessary."
Andriole said that about 70 percent of patients newly diagnosed with prostate cancer cases are in the early stages, meaning the cancer is confined to the prostate gland, and they have nonaggressive tumors.
To evaluate any potential benefits of surgery, the researchers randomly assigned 731 men in the U.S. with localized prostate cancer to receive either surgery or just observation between 1994 and 2002. The average age of men in the study was 67 at the time of enrollment.
Of the 364 men who had prostate cancer surgery, 223, or 61 percent, died of other causes after up to 20 years of follow-up, compared with 245 men, or 66 percent, in the observation group, a difference that is not statistically different.
Further, 27, or seven percent, men in the surgery group died of prostate cancer, compared with 42 men, or 11 percent, in the observation group, but that difference also is not statistically significant.
In addition, of the men treated with surgery, 53, or 15 percent, suffered from erectile dysfunction, and 63, or 17 percent, reported having incontinence. Another 45 developed other complications.
However, the data showed that surgery may have a mortality benefit in some men, particularly those with a long life expectancy and intermediate-risk prostate cancer.
For men with high-risk prostate cancer, surgery is also often beneficial, as are other treatments such as radiation, Andriole added.