Expectant management of stage A-1 (T1a) prostate cancer utilizing serum PSA levels: a preliminary report
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K R Loughlin1, A A Renshaw, S Kumar
1Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
Background And Objectives:
The natural history of stage A-1 (Tla) prostate cancer remains unpredictable. Although stage A-1 (Tla) was traditionally considered an indolent lesion, recent reports have documented the potential progression of stage A-1 (Tla) cancer.
Methods:
Eight men aged 65 to 76 years at the time of diagnosis with stage A-1 (Tla) prostate cancer received no therapy. These men have been followed from 3 to 9.5 years (mean, 6.25 years). During this period, the patients have been followed with periodic rectal examinations and prostate-specific antigen (PSA) levels.
Results:
The PSA levels of five of the eight patients remain in the normal range and no patient has had a change in his rectal examination. In the three patients who had elevated PSA levels, there was no evidence of metastatic disease. No patient has died from prostate cancer; one patient died from cerebrovascular causes.
Conclusions:
Patients with stage A-1 (Tla) prostate cancer have an unpredictable natural history. PSA levels can be used to monitor disease progression and identify those patients where observation is no longer appropriate.
