No Advantages With Aggressive Treatment in Metastatic Prostate Cancer


For men with metastatic prostate cancer, there is no survival advantage for aggressive therapy over conservative androgen deprivation therapy only

Men diagnosed with locally advanced or metastatic prostate cancer were identified. Survival was compared by treatment type: conservative (androgen deprivation therapy only) vs aggressive (radical prostatectomy or any type of radiotherapy). The 9-year overall and prostate cancer-specific survival were estimated.

The researchers found that conservative treatment alone correlated with a 4-fold increased likelihood of prostate cancer mortality vs treatment with surgery for men with advanced, non-metastatic prostate cancer (hazard ratio, 4.18). For men with metastatic disease, after adjustment for covariates, there was no difference between conservative and aggressive treatment. The 9-year prostate cancer-specific survival rates were 27 and 24% for men receiving aggressive treatment and conservative treatment, respectively.

The results of the current study did affirm advantages in the setting of locally advanced disease. Aggressive local therapy in the setting of metastatic disease needs to be studied carefully before clinical adoption.


Dall'Era MA, Lo MJ, Chen J, et al. Nine-year prostate cancer survival differences between aggressive versus conservative therapy in men with advanced and metastatic prostate cancer. Canc. 2 March 2018. DOI: 10.1002/cncr.31285