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Forskningskartlegging

Effectiveness of treatment for localized prostate cancer: evidence base for a shared decision making tool

  • Year: 2019
  • By: Norwegian Institute of Public Health
  • Authors Dalsbø TK, Dahm, KT, Måseide AK, Skjelbakken T.
  • ISBN (digital): 978-82-8406-027-9
Forside Prostata uten spredning.jpg

The Centre for shared decision making (“Samvalgssenteret”) commissioned the Norwegian Institute of Public Health to summarize findings about the effectiveness of relevant treatment for localized prostate cancer.

Downloadable as PDF. In Norwegian with English summary.


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Key message

Prostate cancer is cancer that occurs in the prostate — a small walnut-shaped gland in men that produces the seminal fluid that nourishes and transports sperm. Prostate cancer is one of the most common types of cancer in men. Usually prostate cancer grows slowly and is initially confined to the prostate gland, where it may not cause serious harm. While some types of prostate cancers grow slowly and may need minimal or even no treatment, other types are aggressive and can spread. Prostate cancers that are detected early –  when it's still confined to the prostate gland – have better chance of successful treatment.

The Centre for shared decision making (“Samvalgssenteret”) commissioned the Norwegian Institute of Public Health to summarize findings about the effectiveness of relevant treatment for localized prostate cancer. We found three Cochrane reviews. Bottom line for the main outcome survival is:

  • We don’t know the effectiveness of watchful waiting compared to observation as the systematic review we included had not identified any relevant research
  • Radical prostatectomy probably improves survival at 10-12 years as compared with watchful waiting, but it is uncertain if the difference is maintained at even longer term follow-up.
  • We don’t know the effectiveness of watchful waiting compared to low-dose rate brachytherapy as the systematic review we included had not identified any relevant research
  • There is maybe little or no difference in survival after radical prostatectomy compared to low-dose rate brachytherapy.
  • We don’t know the effectiveness of radical prostatectomy compared to observation as the systematic review we included had not identified any relevant research
  • We don’t know the effectiveness of low-dose rate brachytherapy compared to observation as the systematic review we included had not identified any relevant research

There is little or no difference in five year cancer-free survival when comparing surgery with adjuvant radiotherapy with surgery alone, but adjuvant radiotherapy may improve ten-year survival.