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"Focused on the Prostate since 1996"

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Deferred treatment of clinically localized low-grade prostate cancer: actual 10-year and projected 15-year follow-up of the Karolinska series.

Watchful Waiting or Watchful Progression? Prostate Specific Antigen Doubling Times and Clinical Behavior in Patients with Early Untreated Prostate Carcinoma

The Natural History of Prostate Carcinoma Based on a Danish Population Treated with No Intent to Cure (Borre)

AU - Adolfsson J; Steineck G; Hedlund PO

TI - Deferred treatment of clinically localized low-grade prostate cancer: actual 10-year and projected 15-year follow-up of the Karolinska series.

SO - Urology 1997;50(5):722-6
AD - Department of Urology, Karolinska Institute, Huddinge University
Hospital, Sweden.
AB - OBJECTIVES: To review the outcome in patients with clinically
localized prostate cancer managed conservatively. METHODS: A total of
122 patients with palpable, clinically localized, low-grade prostate
cancer diagnosed from 1978 to 1982 at the Karolinska Hospital,
Stockholm, Sweden, were prospectively followed in a surveillance
protocol followed by treatment when the tumor progressed with
symptoms. RESULTS: All patients but one had been observed for 10
years or more. No antitumoral therapy had been given to 58 (48%)
patients at follow-up or before death. The chance of being untreated
5 and 10 years after diagnosis, if still alive, was 71% and 43%,
respectively. The actual disease-specific survival rate at 10 years
was 90%. Of the patients with a possible observation period of 15
years or more, 25% died of prostate cancer (ie, an actual disease-
specific survival of 75%). Using a survival plot, the projected
disease-specific survival rate at 15 years was 62%. The cumulative
incidence of death from prostate cancer increased with possible
observation time up to 15 years. CONCLUSIONS: Our data are mature up
to 10 years of observation and, based on these data, deferred
treatment is a valid option for patients with clinically localized
low-grade prostate cancer with a life expectancy of 10 years or less.
The data are not definitive beyond 10 years and firm conclusions will
be speculative, but our findings indicate that there probably is room
for efficacious local treatment in patients with localized prostate
cancer and a life expectancy longer than 10 years.