The clinical spectrum of prostate cancer.

Review of 206 consecutive patients with prostatic carcinoma and a potential for 10-year followup indicates the efficacy of vigorous surgical or hormonal management. Satisfactorily documented followup was achieved in 88 per cent of the group for 5 years and 82 per cent of the group for 10 years. Among 33 patients undergoing radical perineal prostatectomy survival rates were 84 per cent at 5 years and 58 per cent at 10 years. In the entire series, irrespective of modality of treatment, approximately half of the patients survived 5 years and a fourth for 10 years. Hormonal therapy of choice was orchiectomy combined with relatively high doses of estrogens, with no indication of significant cardiovascular morbidity or mortality. Interestingly, stage A disease (often diffuse, anaplastic and unsuspected) demonstrated a significantly increased mortality risk when compared to stage B (localized and usually well differentiated) carcinoma of the prostate.