Johansson J E
Abteilung für Urologie, Medizinisches Zentrum Orebro, Schweden.
Urologe A. 1996 Nov;35(6):446-8. doi: 10.1007/s001200050049.
In a population-based study, disease progression and survival were evaluated in primary untreated patients with newly diagnosed cancer of the prostate without distant metastases. Complete follow-up was achieved in 223 eligible patients with localized disease. These patients were treated with hormones if they had symptoms of tumor progression. After a medium observation time of 14 years, 73 patients experienced local tumor progression and 27 (13%) had metastases. Seventy-four percent of the patients had died, but only 11% of prostate cancer. The estimated overall and disease-specific survival after 15 years was 20.7% (95%, confidence interval 14.1-27.3%) and 80.9 (72.4-89.4%), respectively. In a multivariate analysis, tumor grade turned out to be a strong predictor of progression and death due to prostate cancer. The low disease-specific mortality rate, especially in patients with highly and moderately differentiated tumors, means that any therapy intended for patients with early prostate cancer must be evaluated in clinical trials with untreated controls for comparison.
在一项基于人群的研究中，对未经治疗的新诊断为前列腺癌且无远处转移的原发性患者的疾病进展和生存率进行了评估。223例符合条件的局限性疾病患者实现了完整随访。这些患者若出现肿瘤进展症状则接受激素治疗。经过14年的中位观察期后，73例患者出现局部肿瘤进展，27例（13%）发生转移。74%的患者死亡，但前列腺癌导致的死亡仅占11%。15年后估计的总生存率和疾病特异性生存率分别为20.7%（95%置信区间14.1 - 27.3%）和80.9%（72.4 - 89.4%）。在多变量分析中，肿瘤分级被证明是前列腺癌进展和死亡的有力预测因素。低疾病特异性死亡率，尤其是在高分化和中分化肿瘤患者中，意味着任何针对早期前列腺癌患者的治疗都必须在有未治疗对照的临床试验中进行评估以作比较。
