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June 9, 2004

Waiting Time in Prostate Cancer

Author Affiliations

Author Affiliations: Department of Medicine and Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, and the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.

JAMA. 2004;291(22):2757-2758. doi:10.1001/jama.291.22.2757

The study from Johansson and colleagues1 published in this issue of THE JOURNAL illustrates why oncologists often substitute the jargon of survival rates to sidestep using the magic word cure, which is really what's on every patient's mind.1 In this well-conducted investigation, the researchers complete more than 2 decades of follow-up for a cohort of more than 200 Swedish men with early-stage prostate cancer from before the prostate-specific antigen (PSA) era who were treated with watchful waiting. Earlier reports by Johansson et al documented the relatively high rates of recurrence and mortality for those with high-grade tumors and the relatively lower rates among those with low-grade tumors, extending up to about 15 years of follow-up.28 In the current article, the authors extend their follow-up to more than 20 years and find a surprising acceleration in the recurrence and mortality rates of the patients with low-grade tumors.1 The result is that more aggressive disease indeed occurs after 15 years of follow-up for these patients.

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