Radiotherapy of prostatic carcinoma: long- or short-term efficacy (Stanford University experience).

Results of a study that began at Stanford in 1956 demonstrate that long-term, disease-free survival can be achieved following appropriate irradiation in patients with prostatic carcinoma. However, the investigation has also uncovered several powerful prognostic indicators, such as the extent of anatomic involvement, histologic pattern, particularly as described by Gleason; and presence or absence of lymphnode metastases. To illustrate the importance of these parameters, the author presents data that correlate survival with the anatomic extent of the primary tumor and the Gleason pattern scores. Of the staged patients, 64 have been subjected to post-therapeutic biopsy of the prostate 18 months or more following therapy. A correlation also seems to exist among clinical stage, lymph node involvement, and subsequent biopsy status. The implication of this finding in the development of more aggressive therapeutic approaches will be discussed.