NATURAL COURSE OF PRIMARY, UNTREATED, LOC ALIZED PROSTATE-CANCER - THE OREBRO STUDY

In a population-based study, disease progression and survival were eva luated in primary untreated patients with newly diagnosed cancer of th e prostate without distant metastases. Complete follow-up was achieved in 223 eligible patients with localized disease. These patients were treated with hormones if they had symptoms of tumor progression. After a medium observation time of 14 years, 73 patients experienced local tumor progression and 27 (13%) had metastases. Seventy-four percent of the patients had died, but only 11% of prostate cancer. The estimated overall and disease-specific survival after 15 years was 20.7% (95%, confidence interval 14.1-27.3%) and 80.9 (72.4-89.4%), respectively. I n a multivariate analysis, tumor grade turned out to be a strong predi ctor of progression and death due to prostate cancer. The low disease- specific mortality rate, especially in patients with highly and modera tely differentiated tumors, means that any therapy intended for patien ts with early prostate cancer must be evaluated in clinical trials wit h untreated controls for comparison.