Expectant management of localized prostatic cancer

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Abstract
Seventy‐five patients with clinical Stage B histologically proven prostatic cancer accumulated over a 40‐year period and receiving no therapy for at least 1 year after histologic diagnosis were retrospectively reviewed. Twenty‐nine patients had Stage B1 lesions, 37 had B2, and nine had B3 lesions; median follow‐up for these patients was 124, 120, and 96 months, respectively. Five ultimately received pelvic lymph node dissection with iodine‐125 implantation, 23 had transurethral resection of the prostate, and 18 had endocrine therapy. Of those tumors which progressed, 18 of 19 (95%) B1, 26 of 29 (90%) B2, and four of four (100%) B3 lesions demonstrated local progression first. Six of 29 (21%) B1, 17 of 37 (46%) B2, and two of nine (22%) B3 tumors developed recognized distant metastasis. Actuarial survival at 15 years was 67%, 39%, and 63% for patients with B1, B2, and B3 lesions, respectively. These data indicate the varied and potentially protracted course of patients with clinical Stage B prostatic cancer.