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Related Experiment Videos

Deferred treatment in localized prostatic cancer.

J E Johansson1, S O Andersson

  • 1Department of Urology, Orebro Medical Center, Sweden.

Acta Oncologica (Stockholm, Sweden)
|January 1, 1991
PubMed
Summary

Observing early prostate cancer without immediate treatment shows that most men survive long-term. Deferred treatment, particularly hormonal therapy, offers high corrected survival rates for eligible patients.

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Area of Science:

  • Oncology
  • Urology
  • Epidemiology

Background:

  • Early prostate cancer management involves decisions between active treatment and surveillance.
  • Understanding the natural history of untreated localized prostate cancer is crucial for informed clinical practice.

Purpose of the Study:

  • To evaluate the natural history of localized, untreated prostate cancer.
  • To assess progression and survival outcomes in a population-based cohort.
  • To inform treatment strategies for early-stage prostate cancer.

Main Methods:

  • Population-based study of 223 patients with newly diagnosed, untreated localized prostate cancer (T0-2, NX, M0).
  • Longitudinal observation with a follow-up period of 66-150 months.
  • Analysis of progression, metastasis, mortality, and survival rates (observed and corrected).

Main Results:

  • 33% of patients progressed, with 25 developing metastases over 66-150 months.
  • 109 patients died, but only 17 from prostate cancer.
  • Cumulative progression-free survival at 5 and 10 years was 73.1% and 64.3%; corrected survival was 93.8% and 88.7%.

Conclusions:

  • Active surveillance may be a viable option for select patients with early prostate cancer.
  • Hormonal manipulation after symptomatic progression yielded high corrected survival (98.0% at 5 years, 89.1% at 10 years) in a subgroup.
  • A randomized trial comparing deferred treatment with radical prostatectomy has been initiated based on these findings.

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