Natural history of untreated prostate cancer: a comprehensive review of long-term progression patterns and survival outcomes - PubMed

5 days ago

Systematic review of long-term outcomes of untreated prostate cancer across different risk categories.
Ten-year prostate cancer-specific survival varies from >95% for Gleason 6 tumors to <60% for Gleason 8-10 disease.
Grade Group 1 tumors show <5% metastatic risk over 15-20 years, while Grade Groups 4-5 exhibit rapid progression with median disease-specific survival <5 years.
Disease progression accelerates markedly after 15 years across all risk groups.
Men diagnosed after age 75 face substantial competing mortality (~57-60% 10-year non-cancer mortality), regardless of tumor grade.
Tumor grade is the strongest prognostic factor in the natural history of untreated prostate cancer.
Low-grade disease often remains indolent for 15-20 years, whereas high-grade tumors frequently progress to lethal disease within a few years.
Findings support contemporary active surveillance protocols for low-risk patients and inform evidence-based treatment decisions for higher-risk disease.

Hasty Briefsbeta