The course of untreated localized prostate cancer after 10 years of follow-up is at large unknown. As curative treatment is usually only offered patients with a life expectancy exceeding 10 Years, the expected course of the disease if left untreated is of the utmost interest. This paper aims to describe the outcome for patients who survive for more than 10 years when treated without curative intent. The results indicate that cancer specific mortality in patients with localized prostate cancer increases steadily over time and is approximately 50% after 15 years. This is a much higher figure than in reported series on radical prostatectomy. Even if many deaths occur at an old age, prostate cancer death is shown to be associated with a significant morbidity, need for palliative treatment, hospital care and cost. Preventing prostate cancer death is therefore not only a matter of saving year of life but also to prevent suffering caused by the disease. Modern diagnostic tools, such as prostate specific antigen, seem to detect clinically significant cancers in the vast majority of patients. Over diagnosis seems to be uncommon if diagnostic procedures are restricted to patients with a long life expectancy. Localized prostate cancer is a slow-growing but progressive neoplastic disease. When diagnosed in a man with a longer life expectancy it should be handled as such.

译文

:十年随访后未经治疗的局限性前列腺癌的病程目前还不得而知。由于通常仅为预期寿命超过10年的患者提供治愈性治疗,因此,如果不及时治疗,预期的病程将是最重要的。本文旨在描述未经治疗而存活超过10年的患者的预后。结果表明,局部前列腺癌患者的癌症特异性死亡率随时间稳定增加,并且在15年后约为50%。这是一个比已报道的前列腺癌根治术系列高得多的数字。即使许多死亡发生在老年,前列腺癌的死亡也被证明与明显的发病率,姑息治疗的需要,医院护理和费用有关。因此,预防前列腺癌的死亡不仅是挽救生命的一年,而且是预防由该疾病引起的痛苦的问题。现代诊断工具,例如前列腺特异性抗原,似乎可以在绝大多数患者中检测出具有临床意义的癌症。如果诊断程序仅限于预期寿命较长的患者,则过度诊断似乎不常见。局限性前列腺癌是一种生长缓慢但正在进行的肿瘤性疾病。当诊断为预期寿命较长的男性时,应照此处理。

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