{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:49:54Z","timestamp":1792093794498,"version":"4.4.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Urol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare cancer-specific and overall survival between a surgery-based strategy and radiotherapy plus androgen deprivation (RT\u00a0+\u00a0ADT) in intermediate- and high-risk localized prostate cancer, using contemporary real-world data from a Latin American public health system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the state-wide cancer registry of S\u00e3o Paulo, Brazil, we studied men with intermediate- or high-risk localized prostate cancer diagnosed in 2014\u20132023. Treatment was assigned by initial modality (intention-to-treat). The primary outcome was cancer-specific survival (CSS), with overall survival (OS) secondary. Groups were compared after 1:1 propensity-score matching, with weighting and per-protocol sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 21,292 patients, matching yielded 4263 pairs (all standardized mean differences below 0.10). CSS did not differ between RT\u00a0+\u00a0ADT and surgery [hazard ratio 0.87, 95% CI 0.58\u20131.29, p\u00a0=\u00a00.48 (intermediate); 1.00, 95% CI 0.78\u20131.27, p\u00a0=\u00a00.98 (high)]. At 5\u00a0years, CSS with surgery versus RT\u00a0+\u00a0ADT was 98.0% versus 96.6% (intermediate) and 94.9% versus 92.9% (high); OS was 92.6% versus 84.6% and 87.5% versus 82.7%. The crude OS advantage of surgery did not persist after matching (p\u00a0=\u00a00.10; p\u00a0=\u00a00.33). Additional therapy was given to 20.2% of operated men, rising to 48.9% in pN1 disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Surgery and RT\u00a0+\u00a0ADT showed similar cancer-specific and overall survival after adjustment, and surgery frequently entailed multimodal therapy. Both can be presented as alternative therapeutic options in shared decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00345-026-06811-5","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:28:48Z","timestamp":1792092528000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["EQUIPOISE: EQUivalence In Prostate cancer treatment: surgery Or radiotherapy? An Intention-to-treat Survival analysis from real-world Evidence"],"prefix":"10.1007","volume":"44","author":[{"given":"Gustavo A.","family":"Viani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Carolina","family":"Hamamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caio Viani","family":"Arruda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos E.","family":"Cardoso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helio A.","family":"Salmon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo O.","family":"Amaral","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"issue":"3","key":"6811_CR1","first-page":"229","volume":"74","author":"F Bray","year":"2022","unstructured":"Bray F, Laversanne M, Sung H et al (2022) Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 74(3):229\u2013263","journal-title":"CA Cancer J Clin"},{"key":"6811_CR2","doi-asserted-by":"crossref","unstructured":"Mottet N, van den Bergh RCN, Briers E, et al (2021) EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol 79(2):243\u2013262","DOI":"10.1016\/j.eururo.2020.09.042"},{"issue":"4","key":"6811_CR3","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1200\/JCO.2010.31.7305","volume":"29","author":"JM Crook","year":"2011","unstructured":"Crook JM, Gomez-Iturriaga A, Wallace K et al (2011) Comparison of health-related quality of life 5 years after SPIRIT: surgical prostatectomy versus interstitial radiation intervention trial. 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