The PIVOT trial (Prostate Intervention versus Observation Trial) compared radical prostatectomy versus active surveillance for localized prostate cancer. What was the KEY finding regarding overall mortality at 20-year follow-up?

• A Radical prostatectomy significantly reduced overall mortality in all patients
• B Active surveillance was superior to surgery for high-risk localized disease
• C Both groups had identical outcomes regardless of risk stratification
• D No significant difference in overall survival overall, but prostatectomy benefited men with intermediate- or high-risk disease ✓

Explanation

The PIVOT trial (extended follow-up) showed no significant overall mortality benefit from radical prostatectomy compared to observation in the entire cohort of men with localized prostate cancer. However, subgroup analyses suggested that men with intermediate- or high-risk disease may derive greater benefit from surgery, while low-risk patients had equivalent outcomes with observation. This supports active surveillance for low-risk prostate cancer and targeted surgical intervention for higher-risk cases.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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