Association of Radical Local Treatment with Mortality in Men with Very High-risk Prostate Cancer: A Semiecologic, Nationwide, Population-based Study

AbstractBackgroundCurrent guidelines recommend androgen deprivation therapy only for men with very high-risk prostate cancer (PCa), but there is little evidence to support this stance.ObjectiveTo investigate the association between radical local treatment and mortality in men with very high-risk PCa.Design, setting, and participantsSemiecologic study of men aged <80 yr within the Prostate Cancer data Base Sweden, diagnosed in 1998–2012 with very high-risk PCa (local clinical stage T4 and/or prostate-specific antigen [PSA] level 50–200ng/ml, any N, and M0). Men with locally advanced PCa (local clinical stage T3 and PSA level