BACKGROUND The Chinese 2018 guidelines and the current 2014 Chinese Urological Association guidelines for
prostate cancer recommend radical
prostatectomy for Chinese men with localized
prostate cancer as the first choice, but it has treatment-related adverse effects. This study aimed to study morbidity and all-cause mortality following radical
prostatectomy compared with observation for localized
prostate cancer in Chinese men from a single center. MATERIAL AND METHODS Men diagnosed (histologically) as stage T1-T2N×M0
prostate cancer of any grade with 1-year history were included in the analysis. A total of 201 men underwent radical
prostatectomy (RP cohort) and 209 men did not undergo radical
prostatectomy (OS cohort). RESULTS During follow-up (17-24 years), 135 (67%) men died in the RP cohort and 156 (75%) men died in the OS cohort (P=0.103). All-cause mortality was lower for men with
prostate-specific antigen level >10 ng/mL (P<0.0001), Gleason score ≥7 (P=0.004), and high D'Amico
tumor risk scores (P=0.007) if they underwent radical
prostatectomy. Age ≥65 years (P=0.041), Gleason score ≥7 (P=0.049), and
tumor stage ≥2c (P=0.045) were associated with all-cause mortality. CONCLUSIONS The findings from this study showed that radical
prostatectomy has no significant beneficial effects when compared with observation for Chinese men with localized
prostate cancer, unless they had a
prostate-specific antigen level >10 ng/mL, Gleason score ≥7, and high D'Amico
tumor risk scores.