Risk of progression and dying of clinically localized prostate cancer in Japan.

Study was made of the conservative management of 107 men with clinically localized prostate cancer. Distant metastasis developed more frequently in patients with poorly differentiated tumors than in those with well- and moderately differentiated counterparts (P < 0.01). Poorly differentiated histology was strongly associated with cancer-specific death (P < 0.01). The progression-free and cancer-specific survival of patients with stage T1a disease was significantly better than that of patients with stages T1b, T2a-b, and T2c tumors (P < 0.05). Available data clearly demonstrate that prostate cancer is a progressive disease when managed conservatively. Long-term follow-up data indicate the natural history of prostate cancer not to differ significantly according to race, despite noteworthy differences in prevalence and mortality. Patients with localized prostate cancer would be candidates for expectant therapy if they had lower-grade tumors and a life expectancy of 10 years or less. For patients with a 10-year or greater life expectancy and any grade of disease definitive therapy should be applicable.