Surgical Management of Localized and Locally Advanced Prostate Cancer

  • Antoni Vilaseca
  • Daniel P. Nguyen
  • Karim Touijer
Living reference work entry


Localized prostate cancer can be managed with different treatment options based on the risk of progression of the disease and the patient morbidities and preferences. The most accepted treatment options include watchful waiting, external beam radiation therapy, brachytherapy, cryosurgery, high-intensity focused ultrasound, and radical prostatectomy. Radical prostatectomy is associated with excellent oncological outcomes in the localized setting but also with a variable degree of functional adverse events, mainly impotence and incontinence. Modification of the surgical technique with preservation of the neurovascular bundles improves postoperative sexual outcomes and continence. The advent of minimally invasive surgery has contributed to the emergence of many studies investigating the potential benefits on oncological and functional outcomes.

While surgery used to be offered mainly in the low-risk setting and rarely to high-risk patients, it has recently gained importance in the latter group, sometimes as part of a multimodal approach. The main advantages over other treatment options are the pathologic confirmation of the primary tumor grade and the regional staging provided with the pelvic lymph node dissection.


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Antoni Vilaseca
    • 1
  • Daniel P. Nguyen
    • 2
  • Karim Touijer
    • 3
    • 4
  1. 1.Department of UrologyHospital Clinic de BarcelonaBarcelonaSpain
  2. 2.Department of UrologyUniversity of BernBernSwitzerland
  3. 3.Urology Service, Department of SurgeryMemorial Sloan Kettering Cancer CenterNew YorkUSA
  4. 4.Weill Cornell Medical CollegeNew YorkUSA

Section editors and affiliations

  • Thomas Steuber
    • 1
  1. 1.Martini-Klinik am UKE GmbHHamburgGermany

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