Pivot Study results: Surgery vs AS at 12 years

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John T
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Date Joined Nov 2008
Total Posts : 4268
   Posted 5/18/2011 12:30 PM (GMT -6)   

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 5/18/2011 1:07 PM (GMT -6)   
John, that's an interesting piece there.

It somewhat confirms the advice I was given pre-treatment. My surgeon and 3 RO's that have looked at my pre-treatment numbers all agreed that surgery was the best primary treatment for me, since I had several high risk factors going into this PC thing. For me personally, since my primary and seconardy treatments failed quickly, its a mute point. Good info though.

David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 5/18/2011 1:15 PM (GMT -6)   
The median on this study is 10 years, not twelve.

I wonder what the results are for men with a MINIMUM of ten years...

Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Veteran Member

Date Joined Sep 2009
Total Posts : 6078
   Posted 5/18/2011 1:43 PM (GMT -6)   
Thanks for that ,John T. that will make a lot of people here,specialy the elders feel better, or should at least.
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

Veteran Member

Date Joined May 2009
Total Posts : 739
   Posted 5/18/2011 2:23 PM (GMT -6)   
Interesting. I wonder what they did with the AS guys if their PSA began rising quickly after the trial began? Did they offer them surgery at that point? They must have done something as I can't imagine them not being treated because they were in a trial. If they did offer them surgery, radiation, or hormones, that puts the findings in a different light as far as the value of treatment.

Whatever the treatment, this says that after a median of 10 years about half had died but only about 3.5% of all of them had died of PC. I guess that says that either surgery or AS work about as well for 10 years. That's encouraging for those of us in our 60s and 70s.

Another perspective is this. Any cancer kills because the cancer cells multiply to such a large number that they stop essential life functions. So it's
a matter of how many doublings take place from the initial cells. I've heard 40 is a rule of thumb so for the sake of argument say it's 40. That means you're probably not going to die after 35 or 36 or some number less than 40 but when you get to 38 or so there's not much time left. From this line of thinking I could understand how a study like this might not find much difference after 10 years but could suddenly find big differences after 13, 14, or some larger number of years.

Just my thoughts.

Post Edited (reachout) : 5/18/2011 1:27:02 PM (GMT-6)

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