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Gleason score predicted mortality rate to 20 years for untreated early prostate cancer
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 Q In patients with localised prostate cancer, what is the 20 year survival rate?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Oncology ★★★★★☆☆

METHODS

Embedded ImageDesign:

inception cohort followed for a median of 24 years (range 16–33 y).

Embedded ImageSetting:

35 acute care hospitals and 2 Veterans Affairs medical centres in Connecticut, USA.

Embedded ImagePatients:

767 men 55–74 years of age (mean age 69 y) diagnosed with clinically localised prostate cancer between 1 January 1971 and 31 December 1984 who were treated with observation or immediate or delayed androgen withdrawal therapy. Exclusion criteria were surgery, radiation therapy, brachytherapy, known metastatic disease, concomitant cancer, or survival <6 months.

Embedded ImagePrognostic factors:

age at diagnosis, treatment method, comorbid conditions, and tumour grade according to Gleason score (range 2–10; 10 = most undifferentiated).

Embedded ImageOutcomes:

death …

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