The Prostate Cancer Intervention Versus Observation Trial (PIVOT) randomized 731 men with clinically organ-confined (T1-T2) prostate cancer to observation versus radical prostatectomy. The patients had to be <75 years old and have a prostate-specific antigen (PSA) <50 ng/mL, but no restrictions were used for Gleason score. The main finding of the study was that neither the all-cause mortality nor the prostate-cancer mortality differed between groups after a median follow-up of 10 years. The absolute reduction in risk of death from all causes was 2.9% with radical prostatectomy and the relative risk reduction was 12%; however, this was not statistically significant (95% confidence interval 0.71-1.08, P = .22). The absolute risk reduction for prostate cancer mortality was similar (2.6%). Although the relative risk reduction for prostate cancer mortality was more pronounced at 37%, the difference was again not statistically significant (95% confidence interval 0.36-1.09, P = .09). The rate of bone metastasis declined from 10.6% to 4.7% with radical prostatectomy, for a relative risk reduction of 60% (95% confidence interval 0.22-0.70, P < .001).
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Urology
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- A randomized trial comparing radical prostatectomy with watchful waiting in early prostate cancer.N Engl J Med. 2002; 347: 781-789
- Prostate cancer screening in the randomized Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial: mortality results after 13 years of follow-up.J Natl Cancer Inst. 2012; 104: 125-132
- Prostate-cancer mortality at 11 years of follow-up.N Engl J Med. 2012; 366: 981-990
- Accessed July 20, 2012)
Published online: October 04, 2012Timothy J. Wilt, M.D., M.P.H., Michael K. Brawer, M.D., Karen M. Jones, M.S., et al. for the Prostate Cancer Intervention versus Observation Trial (PIVOT) Study Group. N Engl J Med 2012;367:203-213.
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.