Current Urology Reports

, Volume 13, Issue 2, pp 179–186

Radical Prostatectomy as Primary Treatment of High-risk Prostate Cancer

Authors

  • Alexandre Ingels
    • Department of UrologyAPHP, CHU Henri Mondor
  • Alexandre de la Taille
    • Department of UrologyAPHP, CHU Henri Mondor
    • Department of UrologyAPHP, CHU Henri Mondor
    • INSERM U955
Prostate Cancer (R Reiter, Section Editor)

DOI: 10.1007/s11934-012-0240-6

Cite this article as:
Ingels, A., de la Taille, A. & Ploussard, G. Curr Urol Rep (2012) 13: 179. doi:10.1007/s11934-012-0240-6

Abstract

High-risk prostate cancer (PCa), established according to the d’Amico criteria or other prognostic tools, remains very heterogeneous, including a third of patients with excellent prognosis in whom surgical treatment can result in long-term progression-free survival. In contrast, a substantial proportion of high risk will not be cured by local treatment alone and might benefit from a more aggressive multimodal adjuvant treatment strategy. However, to date, except in one adjuvant radiotherapy series, no neoadjuvant or adjuvant therapy has shown a survival improvement after radical prostatectomy for high-risk PCa. Recent observational studies tend to prove that radical prostatectomy may offer benefits over radiotherapy in disease-free and overall survival. However, good Level 1 evidence is lacking and further prospective studies are warranted to directly compare the outcomes of radical prostatectomy to combined radiation and hormonal therapy in high-risk patients.

Keywords

Prostate cancerRadical prostatectomyHigh-risk prostate cancerOutcomesAdjuvantRadiotherapyAdjuvant hormone therapyTreatmentCombination therapyGleason scoreStagingRadical prostatectomy

Copyright information

© Springer Science+Business Media, LLC 2012