title: Expectant management of stage A-1 (T1a) prostate cancer utilizing serum PSA levels: a preliminary report.
abstract: OBJECTIVE
  The natural history of stage A-1 (Tla) prostate cancer remains unpredictable. Although stage A-1 (Tla) was traditionally considered an indolent lesion, recent reports have documented the potential progression of stage A-1 (Tla) cancer.
  
  
  METHODS
  Eight men aged 65 to 76 years at the time of diagnosis with stage A-1 (Tla) prostate cancer received no therapy. These men have been followed from 3 to 9.5 years (mean, 6.25 years). During this period, the patients have been followed with periodic rectal examinations and prostate-specific antigen (PSA) levels.
  
  
  RESULTS
  The PSA levels of five of the eight patients remain in the normal range and no patient has had a change in his rectal examination. In the three patients who had elevated PSA levels, there was no evidence of metastatic disease. No patient has died from prostate cancer; one patient died from cerebrovascular causes.
  
  
  CONCLUSIONS
  Patients with stage A-1 (Tla) prostate cancer have an unpredictable natural history. PSA levels can be used to monitor disease progression and identify those patients where observation is no longer appropriate.
authors.affiliation: Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
authors.forename: K R
authors.initials: KR
authors.lastname: Loughlin
authors.forename: A A
authors.initials: AA
authors.lastname: Renshaw
authors.forename: S
authors.initials: S
authors.lastname: Kumar
mesh_terms: D000368:Aged; D018450:Disease Progression; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000276:immunology* / Q000473:pathology / Q000628:therapy