2000, Volume 3, Issue 1, Pages 37 - 42

Paper

Localized prostate cancer and 30 years of follow-up in a population-based setting J Adolfsson1, H Oksanen2, JO Salo3 & G Steineck4 1Karolinska Institute, Department of Urology, Huddinge University Hospital, Huddinge, Sweden and SBU, The Swedish Council on Technology Assessment in Health Care, Stockholm, Sweden     2The Finnish Cancer Registry, Helsinki, Finland     3Department of Urology, Helsinki University Central Hospital, Helsinki, Finland     4Karolinska Institute, Department of Clinical Epidemiology, Radiumhemmet, Stockholm, Sweden     Correspondence to: J Adolfsson, Karolinska Institute, Department of Urology, Huddinge University Hospital, S-141 86 Huddinge, Sweden. E-mail: adolfsson@sbu.se

Keywords

prostate cancer;   long-term follow-up;   disease-specific survival

Abstract

Some patients with a histopathological diagnosis of prostate cancer have a tumour that behaves benignly during long-term follow-up. The proportion of patients with such a tumour is unknown, as is the fraction who die of prostate cancer between 10 and 20 y of follow-up. All men aged 45-84 y obtaining a diagnosis of prostate cancer between 1965 and 1993 and being reported to the Finnish Cancer Registry were observed. Death was recorded as caused by prostate cancer or not. We identified 11,500 men with localized prostate cancer and in this group the disease-specific survival rate reached a plateau at approximately 30% after 23 y of follow-up. In the same cohort, 5% of the patients died of prostate cancer during years 11-20 of follow-up. During the observation period, somewhat less than half of the patients with localized prostate cancer who died, died of the disease. This proportion decreased with duration of follow-up. In conclusion, early aggressive therapy for localized prostate cancer is unnecessary, in terms of survival, for those with a benignly behaving tumour (about 30% in this series) or who die of intercurrent disease (about 50% in this series). Such therapy may, however, prolong life for the patients and may cure the patients that die of prostate cancer after more than 10 y follow-up. Prostate Cancer and Prostatic Diseases (2000) 3, 37-42

Received 21 October 1999; Revised 14 March 2000; Accepted 15 March 2000

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