Deferred treatment of clinically localized low-grade prostate cancer: actual 10-year and projected 15-year follow-up of the Karolinska series - PubMed (original) (raw)
Clinical Trial
Deferred treatment of clinically localized low-grade prostate cancer: actual 10-year and projected 15-year follow-up of the Karolinska series
J Adolfsson et al. Urology. 1997 Nov.
Abstract
Objectives: To review the outcome in patients with clinically localized prostate cancer managed conservatively.
Methods: A total of 122 patients with palpable, clinically localized, low-grade prostate cancer diagnosed from 1978 to 1982 at the Karolinska Hospital, Stockholm, Sweden, were prospectively followed in a surveillance protocol followed by treatment when the tumor progressed with symptoms.
Results: All patients but one had been observed for 10 years or more. No antitumoral therapy had been given to 58 (48%) patients at follow-up or before death. The chance of being untreated 5 and 10 years after diagnosis, if still alive, was 71% and 43%, respectively. The actual disease-specific survival rate at 10 years was 90%. Of the patients with a possible observation period of 15 years or more, 25% died of prostate cancer (ie, an actual disease-specific survival of 75%). Using a survival plot, the projected disease-specific survival rate at 15 years was 62%. The cumulative incidence of death from prostate cancer increased with possible observation time up to 15 years.
Conclusions: Our data are mature up to 10 years of observation and, based on these data, deferred treatment is a valid option for patients with clinically localized low-grade prostate cancer with a life expectancy of 10 years or less. The data are not definitive beyond 10 years and firm conclusions will be speculative, but our findings indicate that there probably is room for efficacious local treatment in patients with localized prostate cancer and a life expectancy longer than 10 years.
Similar articles
- Deferred treatment of locally advanced nonmetastatic prostate cancer: a long-term followup.
Adolfsson J, Steineck G, Hedlund PO. Adolfsson J, et al. J Urol. 1999 Feb;161(2):505-8. J Urol. 1999. PMID: 9915436 - Adenocarcinoma of the prostate in Iceland: a population-based study of stage, Gleason grade, treatment and long-term survival in males diagnosed between 1983 and 1987.
Jonsson E, Sigbjarnarson HP, Tomasson J, Benediktsdottir KR, Tryggvadottir L, Hrafnkelsson J, Olafsdottir EJ, Tulinius H, Jonasson JG. Jonsson E, et al. Scand J Urol Nephrol. 2006;40(4):265-71. doi: 10.1080/00365590600750110. Scand J Urol Nephrol. 2006. PMID: 16916765 - Should we treat localized prostate cancer? An opinion.
Menon M, Parulkar BG, Baker S. Menon M, et al. Urology. 1995 Nov;46(5):607-16. doi: 10.1016/S0090-4295(99)80289-1. Urology. 1995. PMID: 7495109 - Natural course of localized prostate cancer. a personal view with a review of published papers.
Hugosson J, Aus G. Hugosson J, et al. Anticancer Res. 1997 May-Jun;17(3A):1441-8. Anticancer Res. 1997. PMID: 9179181 Review. - [Competitive morbidity ant its impact on life expectancy: evaluation and inclusion in the therapeutic decision regarding localized prostatic cancer].
Soulié M, Villers A, Richaud P, Prapotnich D, Ruffion A, Grosclaude P. Soulié M, et al. Prog Urol. 2001 Dec;11(6):1195-204. Prog Urol. 2001. PMID: 11859652 Review. French.
Cited by
- Active Surveillance for Prostate Cancer: Past, Current, and Future Trends.
de Vos II, Luiting HB, Roobol MJ. de Vos II, et al. J Pers Med. 2023 Apr 3;13(4):629. doi: 10.3390/jpm13040629. J Pers Med. 2023. PMID: 37109015 Free PMC article. Review. - Long-term oncologic outcomes after radical prostatectomy in clinically localized prostate cancer: 10-year follow-up in Korea.
Suh J, Jung JH, Jeong CW, Lee SE, Lee E, Ku JH, Kim HH, Kwak C. Suh J, et al. Investig Clin Urol. 2020 May;61(3):269-276. doi: 10.4111/icu.2020.61.3.269. Epub 2020 Apr 21. Investig Clin Urol. 2020. PMID: 32377602 Free PMC article. - Hsp-27 expression at diagnosis predicts poor clinical outcome in prostate cancer independent of ETS-gene rearrangement.
Foster CS, Dodson AR, Ambroisine L, Fisher G, Møller H, Clark J, Attard G, De-Bono J, Scardino P, Reuter VE, Cooper CS, Berney DM, Cuzick J. Foster CS, et al. Br J Cancer. 2009 Oct 6;101(7):1137-44. doi: 10.1038/sj.bjc.6605227. Epub 2009 Aug 25. Br J Cancer. 2009. PMID: 19707199 Free PMC article. - Prostate cancer (early).
James ML. James ML. BMJ Clin Evid. 2006 Oct 1;2006:1805. BMJ Clin Evid. 2006. PMID: 19454100 Free PMC article. Review. - Clinical Evidence: Non-metastatic prostate cancer.
Wilt TJ, Brawer MK. Wilt TJ, et al. West J Med. 1999 Aug;171(2):97-101. West J Med. 1999. PMID: 18751181 Free PMC article. No abstract available.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical