Long-term survival in prostatic carcinoma, with special reference to age as a prognostic factor. A nation-wide study

A total of 44,300 cases of prostatic cancer, comprising 90% of all newly diagnosed cases reported to the Swedish Cancer Registry in 1960 through 1978, constituted a cohort followed up for 1-19 years. Survival rates were adjusted for expected mortality in the general population, and were expressed as relative survival (RS). RS for the total cohort after 5, 10 and 15 years was 51, 34 and 24%, respectively, with an annual excess death rate of about 8% which persisted also after long-term observation. RS was similar in the age groups between 45 and 74 years, whereas among patients older than 74 at diagnosis, approximately 10% lower RS appeared early and was persistent. These data demonstrated that the highly varying natural course of prostatic cancer is only slightly related to patient age at diagnosis. The low long-term relative survival rate definitely contradicted the concept that biologically inactive (latent) tumours constitute a significant proportion of the prostatic cancers diagnosed in clinical practice.