[Onset of and survival in adenocarcinoma of the prostate. Analysis of 48 consecutive cases studied over 10 years].

Four hundred and thirty-eight men with histologically confirmed prostatic adenocarcinoma were diagnosed consecutively and followed up closely for up to ten years. The mean age at presentation was 72.5 years and ranged from 45.3 to 91.0 years. Half of the total presented with symptoms of increasing urinary outflow obstruction and a quarter with acute urinary retention. One fifth of the total were diagnosed incidentally and these men had markedly less risk of progressing to skeletal metastases than those with localised, but clinically detectable disease. Most (60%) had locally advanced or metastatic disease at the time of diagnosis and the prevalence of skeletal metastases was seen to increase with local tumour stage. 40% had skeletal metastases at diagnosis and less than half of these patients survive two years. High grade tumours were associated with poor outcome, with a five year survival of less than 20% when the Gleason sum score was greater than seven.