Editorial Comment to: SAMS: A randomized study comparing two different follow-up schedules for active surveillance of low-risk prostate cancer

摘要

After Patrick Walsh published his "anatomical nerve sparing" technique, radical prostatectomy (RP) became the mainstream for treatment of local prostate cancer (1). The level 1 evidence for the benefit came years later when results of the SPCG-4 trial were published (2). Unfortunately, due to the widespread use of PSA for early diagnostics (or even screening) we were actually not treating the patients we had the evidence for. We were and are treating patients with much better prognosis. Clinical trials comparing different treatments for local prostate cancer are extremely difficult to execute. Hundreds, if not thousands, of patients and one to two decades of follow-up are needed to examine survival endpoints.