Men with localised prostate cancer have high long-term survival rates regardless of whether they choose a ‘watch and wait’ approach or radical treatment, a landmark study shows.

Although prostatectomy and radiotherapy cut the incidence of metastasis and local progression by half compared to active monitoring, UK researchers say these reductions did not translate to a mortality benefit.

Overall, just 45 out of 1610 patients, or 3%, died from prostate cancer during a median 15 years’ follow-up, with no significant difference in mortality between treatment type.

“Our findings indicate that depending on the extent of side effects associated with early radical treatments, more aggressive therapy can result in more harm than good,” the University of Oxford-led team report in The New England Journal of Medicine.