RISK OF PROGRESSION AND DYING OF CLINICALLY LOCALIZED PROSTATE-CANCERIN JAPAN

Study was made of the conservative management of 107 men with clinical ly localized prostate cancer. Distant metastasis developed more freque ntly in patients with poorly differentiated tumors than in those with well- and moderately differentiated counterparts (P < 0.01). Poorly di fferentiated histology was strongly associated with cancer-specific de ath (P < 0.01). The progression-free and cancer-specific survival of p atients with stage Tla disease was significantly better than that of p atients with stages T1b, T2a-b, and T2c tumors (P < 0.05). Available d ata clearly demonstrate that prostate cancer is a progressive disease when managed conservatively. Long-term follow-up data indicate the nat ural history of prostate cancer not to differ significantly according to race, despite noteworthy differences in prevalence and mortality. P atients with localized prostate cancer would be candidates for expecta nt therapy if they had lower-grade tumors and a life expectancy of 10 years or less. For patients with a 10-year or greater life expectancy and any grade of disease definitive therapy should be applicable.