Current Urology Reports

, Volume 13, Issue 2, pp 179–186

Radical Prostatectomy as Primary Treatment of High-risk Prostate Cancer

  • Alexandre Ingels
  • Alexandre de la Taille
  • Guillaume Ploussard
Prostate Cancer (R Reiter, Section Editor)


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.


Prostate cancer Radical prostatectomy High-risk prostate cancer Outcomes Adjuvant Radiotherapy Adjuvant hormone therapy Treatment Combination therapy Gleason score Staging Radical prostatectomy 


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Alexandre Ingels
    • 1
  • Alexandre de la Taille
    • 1
  • Guillaume Ploussard
    • 1
    • 2
  1. 1.Department of UrologyAPHP, CHU Henri MondorCréteilFrance
  2. 2.INSERM U955CréteilFrance

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