Study findings published in the Journal of the National Comprehensive Cancer Network (NCCN) showed encouraging long-term survival outcomes following NCCN guideline-recommended treatment for nonmetastatic prostate cancer.1
Among patients with low-risk disease, the 15-year prostate cancer mortality was 5.5%.
Overall, data showed that for patients with low- to intermediate-risk prostate cancer, the risk of prostate cancer mortality was 6 times lower than the risk of mortality from other causes. Further, in patients with high-risk prostate cancer, the risk of prostate cancer mortality was still 2 times lower than the risk of mortality from other causes.
“Our data support adherence to guideline recommendations for treatment of prostate cancer,” said lead author Pietro Scilipoti, MD, of Uppsala University in Sweden and IRCCS San Raffaele Hospital in Italy, in a news release on the findings.2 “If guideline-recommended treatment is used, most people with prostate cancer will live for many years after diagnosis. That includes active surveillance as an excellent treatment strategy for appropriately selected people.”
In total, the study included data from 135,636 patients in Sweden who had nonmetastatic prostate cancer and a life expectancy greater than 3 years. Among these patients, 62,839 (46%) received treatment in accordance with NCCN guidelines.
The median age of patients was 67 years (IQR, 62 to 73), and the median life expectancy was 18 years (IQR, 13 to 22). Overall, 42% of patients received radical prostatectomy, 22% received radiotherapy with or without androgen deprivation therapy, and 20% underwent active surveillance.
Among patients with low-risk disease, the 15-year prostate cancer mortality was 5.5% (95% CI, 4.8 to 6.2), and mortality from other causes was 37% (95% CI, 35 to 39). Among patients with very high-risk prostate cancer, the 15-year mortality rate was 22% (95% CI, 21 to 24) for prostate cancer and 36% (95% CI, 34 to 38) from other causes.
The estimated 30-year mortality rate among patients with low-risk prostate cancer was 12% (95% CI, 10 to 14) from prostate cancer and 77% (95% CI, 74 to 80) from other causes. For patients with high-risk prostate cancer, mortality was 20% (95% CI, 18 to 22) from prostate cancer and 67% (95% CI, 61 to 73) from other causes. Among those with very high-risk prostate cancer, prostate cancer mortality was 30% (95% CI, 29 to 32), and mortality from other causes was 63% (95% CI, 59 to 67).
Data also showed that mortality from prostate cancer and from other causes varied according to life expectancy within each risk category. For example, for those with low-risk disease and a life expectancy greater than 15 years, 15-year prostate cancer mortality was 2.5%, and mortality from other causes was 20%. In patients with low-risk disease and a life expectancy less than 10 years, 15-year prostate cancer mortality was 10%, and mortality from other causes was 81%.
“This study offers a big sigh of relief for many men facing a prostate cancer diagnosis,” concluded Ahmad Shabsigh, MD, of The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, Member of the NCCN Guidelines Panel for Prostate Cancer, in the news release.2 “It reveals that with NCCN Guidelines-recommended treatment, you’re significantly more likely to die from something else—up to 6 times more likely, in fact—even if your cancer is high-risk. This holds true even when looking at data from a different health care system, like Sweden’s. What’s truly striking is that for patients with low-risk prostate cancer, many of whom were on active surveillance, the 30-year mortality risk from the cancer itself was only about 11%. It really underscores the power of evidence-based treatment plans and the importance of focusing on a person’s overall health, not just their cancer.”
REFERENCES
1. Scilipoti P, Bratt O, Garmo H, et al. Long-term outcomes after guideline-recommended treatment of men with prostate cancer. J Natl Compr Canc Netw. 2025;23(7):e257022. doi:10.6004/jnccn.2025.7022
2. New research in JNCCN offers reassurance about localized prostate cancer prognosis. News release. National Comprehensive Cancer Network. July 8, 2025. Accessed July 14, 2025. https://www.newswise.com/articles/new-research-in-jnccn-offers-reassurance-about-localized-prostate-cancer-prognosis