How should the outcomes and QOL results of the ProtecT Trial be interpreted?

The trial is a masterpiece. Quality assurance on the treatments, complete follow-up, careful cause-of-death ascertainment, pristine and long term quality of life data.

My conclusions:

1. The vast majority of men with low-risk and low-intermediate risk disease do not benefit from immediate treatment. I...

Great summary by Anthony and great discussion on this important trial.

I want to point out a couple of small points which can be easily missed:

- The radiation used in the ProtecT trial was 3D conformal, not IMRT. Remember that the trial started in 1999. It is quite possible that with modern IMRT, t...

Worth emphasizing from the article: “The majority of men who were randomly assigned to active monitoring (88%) accepted their treatment assignment, but a quarter of them received radical treatment within 3 years after their initial assignment and over half by 10 years.” Low risk patients can safely ...

Good study, but I don't see this changing patterns of practice very much in the US (at least in community practice) as long as urologists continue to manage and diagnose these patients upfront.

The USPSTF guidelines did cause a drop off in the numbers of cases/diagnoses but that was probably happeni...

An excellent commentary by @Dr. First Last and thoughtful inputs from others.

This trial provides urgent need-to-know data for all oncologists. I recommend looking also at the appendix, available online, to be able to appreciate all the finer points.

In my opinion the trial also validates the ASTRO ...