Incidental prostate cancer-prognostic factors. A population based-study from Orebro,Sweden with 20 years follow-up.

O Andren, Swen-Olof Andersson, Lennart Franzen and Jan-Erik Johansson.

Department of Urology and Department of Pathology, University hospital of Orebro Sweden.

AIM Studies of the natural history of prostate cancer, have revealed a highly variable course. Therefore there is an urgent need to find reliable prognostic factors that could be helpful in choosing type of treatment. In this study, which is part of an earlier published and debated study of the natural history of prostate cancer from Orebro Sweden, we have assessed some possible prognostic factors. Method Of 642 consecutively diagnosed prostate cancer from March 1977 through February 1984, 105 non-palpable tumours(T1a and T1b), with 20 years follow-up, were diagnosed after TUR-P or transvesical operation for benign disease. The prognostic value of Gleason score, nuclear atypia, tumorgrade,percentage of chips with cancer of the specimen, tumour stage and age was analysed. Results During a mean observation period of 21 years 18 patients(17,1%) died due to prostate cancer. Another 4 patients(3,8%9 developed metastasis and further 15 patients(14,3%) got local progression. Of the patients who died due to prostate cancer 31%(5) had Gleason score> 7, 24%(3) had > 50% chips with cancer and 25%(4) poorly differentiated tumours. The mean survival time of all patients was 100 month. Among those with Gleason score > 7 it was 77 months and in the group with > 50% chips with cancer 84 months. Conclusions In this study of 105 patients with voiding symptoms and incidental prostate cancer Gleason score, tumour differentiation and percentage of chips with cancer in specimen turned out to be of prognostic value.

KEY WORDS: Prostate cancer, voiding symptoms, prognostic factors, Gleason score.

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Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Paris, France; February 9 - 12, 2002; in the section on Prognostic Markers.