15-YEAR FOLLOW-UP OF CLINICALLY LOCALIZED PROSTATE-CANCER TREATED CONSERVATIVELY

Background - The outcome of patients with localized prostate cancer fo llowing aggressive treatment or observation with delayed hormonal ther apy is controversial. Method - One hundred and one patients with clini cally localized prostate cancer were followed up retrospectively for 1 5 years, All patients were treated conservatively, followed by delayed hormone therapy. Results - The ten-year survival rates for stages A2, B and C were 60%, 59% and 13% respectively !stages A2, B to C, p<0.00 1). No differences in survival were observed between patients with sta ges A:! and B over 15 years of follow-up (p=0.6). The median time inte rvals to prostate cancer death for patients with stage A2 and C neopla sms were 144 and 72 months respectively. Patients with stage B have no t get reached the median survival time, (A2, B versus C, p<0.001, and A2 versus B, N.S.). Analysis of patients outcome according to histolog ical grade revealed a prognostic advantage for those with well differe ntiated tumors (G1). At 10 gears after diagnosis only 22% of patients with G1 tumors had died in comparison with 100% of the G3 group (p<0.0 01). Grade and stage were significantly correlated (R=0.2, p=0.04). Co nclusions - The findings of our study suggest that conservative treatm ent can be offered as an alternative to the aggressive treatment modal ity in patients with clinically localized prostate cancer, who have a 10 year or lower life expectancy.