Surgery compared to radiation therapy can give patients with localized prostate cancer a better chance of survival, according to a Meta-analysis retrospective study. ”In the past, studies have typically compared the success rates of surgery versus radiation therapy, but we were confused by the methodology.” So says Professor Robert Nam of the University of Toronto, Canada. ”We evaluated all the high-quality data and compared the information on surgery versus radiation therapy in them. The evidence was overwhelming and incontrovertible: overall, surgery outperformed radiotherapy in terms of mortality; however, there were other areas where radiotherapy was more effective than surgery. Therefore, it is quite important to discuss treatment options with patients in the clinical setting.” Dr. Nam said. The Meta-analysis, published online Dec. 15 in EuropeanUrology, included 19 studies of a total of 11,830 patients with localized prostate cancer in low- and intermediate-risk patients. All of these patients had been treated with either surgery or radiation therapy. Overall mortality was higher in the radiotherapy group than in the surgical group (10 studies, aHR 1.63; p<0.00001). In terms of prostate cancer-specific mortality, the radiotherapy group was still higher than the surgical group (15 studies, aHR 2.08; p<0.00001). The researchers believe this is the most impeccable Meta-analysis to date of studies comparing the effects of surgery versus radiation therapy for localized prostate cancer. "Both treatment approaches should be discussed with patients prior to treatment. It is important that this analytical study provides information to patients and physicians about when they should decide which treatment to use." Dr. Nicolas Mottet added, "This systematic review study shows that survival rates for patients after surgery are higher than for all forms of radiation therapy. This should be of interest to researchers." "In any case, conclusive evidence still needs to be validated by a large well-managed randomized controlled trial, such as the upcoming PROTECT trial. We should certainly consider the findings of this study carefully, though it doesn't yet tell us exactly how we should go about treating it. Perhaps this study will not change clinical practice, but at least it gives us fairly important information."