Radical prostatectomy for high-risk prostate cancer.
The prostate-specific antigen (PSA) era has changed the pattern of prostate cancer at presentation. Patients now present with lower-stage, lower-risk disease. However, some patients continue to present with high-risk prostate cancer (high-risk PC), and the effect of PSA introduction on outcome is less clear. This review highlights the salient features of why radical prostatectomy should be considered in the management of men with high-risk PC (Gleason score 8-10, marked increase in PSA levels and advanced clinical T stage). Radical retropubic prostatectomy (RRP) can provide durable local control, long-term cancer-specific survival and accurate pathologic staging, and may guide further individualized treatment. For these reasons, RRP remains the best single treatment of high-risk PC in operable patients.
Department of Urology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
R Jeffrey
RJ
Karnes
Tadashi
T
Hatano
Michael L
ML
Blute
Robert P
RP
Myers
D006801:Humans; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000503:physiopathology / Q000601:surgery*; D012307:Risk Factors; D016896:Treatment Outcome
D017430:Prostate-Specific Antigen