Expectant management of clinically localized prostatic cancer

Among approximately 4,000 prostatic cancer registrations 75 patients with clinical stage B histologically proved prostatic cancer receiving no therapy for at least 1 year after diagnosis were identified and managed expectantly. Of the patients 29 had stage B1, 37 stage B2 and 9 stage B3 lesions. Eight patients ultimately elected definitive radiation treatment. First evidence of tumor progression was local in more than 90% of the cases. Overall median intervals were 78 months to local progression, 186 months to metastasis, 108 months to initiation of any treatment and 156 months to death. The rate of tumor progression was often consistent with protracted survival. Prostatic cancer and co-morbidity were each significant forces of mortality.