From July 1969 to May 1994, radical prostatectomy was performed in 630
patients with clinically localized prostate cancer at the Department
of Urology, University of Wurzburg Medical School. These included 74 p
atients subsequently followed up for 15 years or more 15 years (15-23
years, mean 17.5 years), who were the subjects of the present study. O
f these 74 patients 59 had pT2 tumors and 10 had pT3 tumors according
to the staging criteria of the 1992 edition of the UICC TNM classifica
tion. The remaining 5 patients had microscopic lymph node metastases d
etected at staging pelvic lymphadenectomy (stage pT2-3pN1-2). Patients
with lymph node involvement were treated by immediate orchiectomy. Al
l other patients received no further treatment until progression occur
red. The overall 15-year survival rate actually observed the 74 patien
ts was 50% (37/74) and the disease-free survival rate was 43.2% (32/74
pts). Stage-related overall and disease-free survival rates were foun
d to be 54.2% and 49.1%, respectively, for patients with pT2 tumors, 4
0% and 30% for those with pT3 tumors, and 20% and 0 for patients with
lymph node metastases. Progression (either local recurrence or distant
metastatic spread) was noted in 22 of the 74 patients (29.7%) within
the 15-year period following radical prostatectomy, Mean time to progr
ession was 7.9 years (3 months to 17 years), Within the follow-up peri
od, 17 patients (23%) died of prostate cancer. These actual 15-year fo
llow-up data show radical prostatectomy to be the most effective means
of achieving long-term disease-free survival, if not cure, in patient
s with clinically localized prostate cancer.