The ProtecT trial compared active monitoring, radical prostatectomy, and radiotherapy for localised prostate cancer. The primary outcome at 15-year follow-up regarding prostate cancer mortality was:
- A Radical prostatectomy was superior to both radiotherapy and monitoring
- B Active monitoring had unacceptably high cancer-specific mortality
- C No significant difference in prostate cancer-specific mortality among the three groups ✓
- D Radiotherapy had the highest rate of biochemical recurrence
Correct answer: C. No significant difference in prostate cancer-specific mortality among the three groups
Explanation
The ProtecT trial 15-year data (2023) confirmed no significant difference in prostate cancer-specific mortality among active monitoring, radical prostatectomy, and radiotherapy for localised prostate cancer (all <3%). However, active monitoring was associated with higher rates of metastasis and disease progression compared to treatment arms. This has refined the debate: treatment reduces metastatic progression but may not extend cancer-specific survival in low-risk disease.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.