A challenge to contemporary management of prostate cancer

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Abstract
The report by Bill-Axelson et al. challenges current paradigms for diagnosis and treatment of prostate cancer. Contemporary dogma based on 8-year outcomes holds that early diagnosis and treatment improve survival, but after 12 years' follow-up, this study showed no significant difference in overall survival between men randomly allocated radical prostatectomy and those managed with observation. A modest improvement in prostate-cancer-specific survival was only observed in men with a Gleason score of ≥7 who were 65 years old, are probably best served by active surveillance.