Carcinoma of the prostate

This is a review of 205 patients treated at this institution from 1975 to 1982 with external beam radiation. The histologic diagnoses were established by means of needle biopsy (60%) or transurethral resection (40%) of the prostate. The staging workup included acid phosphatase measurements, CT, and bone scanning. Fifty-one patients underwent staging lymphadenectomy. there were 28 patients with A2, 91 with stage B, and 86 with stage C disease. The histologic grade was available in over 90% (46 grad I, 89 grade II, 55 grades III-IV). Seventeen patients had histologically proved positive nodes. The median follow-up was 7.4 years, with a range of 5-12 years. The 5-year overall and disease-free survival were 71% and 60%, respectively. Survival and disease-free survival according to stage were 90% and 60% for stage A2, 80%, and 64% for stage B, and 56% and 47% for stage C. For patients with positive nodes, the disease-free survival was 18%, in contrast to 82% for patients with negative nodes. Local control of the disease was achieved in 93%. Fourteen patients (6.8%) developed late complications, and one patient required surgical intervention