Metastatic Disease Progression(12.2 percentage point difference): The incidence of distant metastases was 26.1% in the radical prostatectomy group and 38.3% in the watchful-waiting group.
Hormone Therapy (24.9 percentage point difference): The use of androgen-deprivation was 42.5% in the radical prostatectomy group and 67.4% in the watchful waiting group.
Other Palliative Treatments: Radiation therapy in the radical prostatectomy was 49% versus 63% in the watchful-waiting group. Also 4 men in the radical prostatectomy group underwent laminectomy due to metastases. There was also a decrease of chemotherapy in the radical prostatectomy group.
Age/Risk Analyses: Men that were younger than 65 and men with intermediate-risk tumors had the most significant differences. Also, men older than 65 years of age who underwent radical prostatectomy had a more significant decrease in risk of metastases and need for additional therapy. Older men showed an increased risk in death from causes other than prostate cancer.
Quality of Life: Metastases and the use of hormone therapy are strongly associated with a reduced quality of life. Measures to show quality of life were erectile dysfunction (ED) and urinary leakage. There was erectile dysfunction in of 84% in the radical prostatectomy group and 80% in the watchful waiting group (only a 4 percentage point difference). The bigger measure was in urinary leakage with shows 41% (surgery) and 11%, (watchful waiting)