Prostate carcinoma: an autopsy evaluation of the influence of age, tumor grade, and therapy on tumor biology.

This report represents a review of 1,641 routine autopsies. Prostate carcinoma was identified in 172 cases (10% of all autopsies) and was the direct or contributing cause of death in 29 (2%). Frequency of prostate carcinoma increased with increasing age, but the mortality rate was inversely related to age as indicated by 30% mortality in those younger than 60 years old, 24% of those between 60 and 70 years old, and 7.5% of those older than 70 years. Of those with carcinoma, 83% died of other, unrelated causes; of those who died, 80% had poorly differentiated (grade 3 or 4) tumors. Given the indolent biologic nature of well differentiated tumors in those older than 70 years, prostate carcinoma should not in most instances be regarded as life-threatening with or without treatment in older individuals. The tumor seems to be biologically more aggressive in younger men, especially those younger than 60 years.