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Journal of the National Cancer Institute Advance Access originally published online on August 11, 2008
JNCI Journal of the National Cancer Institute 2008 100(16):1123-1125; doi:10.1093/jnci/djn259
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Published by Oxford University Press 2008.

EDITORIALS

SPCG-4: A Needed START to PIVOTal Data to Promote and ProtecT Evidence-Based Prostate Cancer Care

Timothy J. Wilt

Affiliation of author: Minneapolis VA Center for Chronic Disease Outcomes Research, Minneapolis, MN

Correspondence to: Timothy J. Wilt, MD, MPH, Minneapolis VA Center for Chronic Disease Outcomes Research, 1 Veterans Drive (111-0), Minneapolis, MN 55417 (e-mail: tim.wilt@va.gov).

The first 150 words of the full text of this article appear below.

Surgical removal of the prostate for cancer therapy was first performed in 1866 (1), although Young (2) is credited with the first radical surgical procedure in 1904. Prostate cancer deaths were rarely reported in the 1800s, but the relatively high frequency of asymptomatic disease was recognized as early as 1898 (3). Radical prostatectomy has been widely advocated as an effective treatment for localized prostate cancer. However, the only prior randomized trial comparing surgery to watchful waiting (4), begun 40 years ago, failed to demonstrate a survival difference even at 23 years of follow-up. Twenty years ago Whitmore (5) asked these questions regarding the natural history and treatment of prostate cancer: "Is cure necessary in those for whom it is possible and is cure possible in those for whom it is necessary?" Recent systematic reviews have been unable to address Dr . . . [Full Text of this Article]


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