Management of localized prostate cancer: the pendulum swings (back to the middle).

Amongst patients with low-risk disease (defined as a PSA <10 ng ml −1 and Gleason <7), there was a significant reduction in both all-cause mortality and distant recurrence with RP and a nonsignificant trend towards reduction in prostate-cancer related mortality.

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High-risk patients treated with surgery had a strong trend toward improvement in death from prostate cancer (HR = 0.4, 95% CI = 0.16–1.00), but this subset was too underpowered to be conclusive.

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