DEFINITIVE THERAPY FOR PROSTATE CARCINOMA - MAYO-CLINIC RESULTS AT 15YEARS AFTER TREATMENT

Data on long-term follow-up for definitive therapy of prostate cancer are limited, especially for radiation therapy. Either surgery or radia tion was used in 322 patients for treatment with curative intent, and follow-up was for a minimum of 15 years. Overall survival was nearly i dentical to that in an age-matched cohort. 5-, 10-, and 15-year recurr ence-free survival rates were 77%, 63% and 53%, respectively. Grade an d stage were significant prognostic factors for both recurrence and su rvival. More than 60% of the initial failures were local, and more tha n 25% of the failures occurred after 10 years. Radiation therapy was u sed in 137 patients with clinically staged disease. Radical retropubic prostatectomy and perineal prostatectomy were performed in 133 and 44 patients, respectively. In this group, pathological staging was used. Survival rates for surgically treated patients were better than those in the cohort population. In conclusion, overall long-term follow-up demonstrates that definitive treatment does not have an adverse effect on survival from prostate cancer. Local recurrence is a frequent caus e of failure. Caution must be used in interpreting any prostate study with less than 10 years of follow-up, because 25% to 50% of the failur es occur after that time.