The PIVOT trial compared radical prostatectomy to active observation in localized prostate cancer. Its primary finding after 20 years of follow-up was:

• A Radical prostatectomy significantly improved overall survival in all PSA risk groups
• B Radical prostatectomy reduced prostate cancer mortality in high-risk but not low-risk disease ✓
• C Active observation was equivalent to surgery for overall survival in all risk groups
• D Radical prostatectomy reduced distant metastases in intermediate-risk disease only

Explanation

The PIVOT (Prostate Intervention Versus Observation Trial) 20-year follow-up demonstrated that radical prostatectomy significantly reduced prostate cancer-specific mortality and all-cause mortality in men with PSA >10 ng/mL or high-risk disease, but showed no significant benefit over observation in men with low-risk prostate cancer (PSA ≤10, Gleason ≤6). This trial supports risk-stratified treatment decisions: active surveillance for low-risk disease and radical treatment for high-risk disease.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.