High-risk localized prostate cancer: role of radical prostatectomy.
OBJECTIVE
The paucity of randomized trials comparing curative management strategies for high-risk prostate cancer makes treatment decisions in this patient population difficult. Although in the past, high-risk patients have primarily been sent for radiation therapy due to concerns that surgery was not likely to be curative and associated with high side-effect profile, there is renewed interest in radical prostatectomy as the primary treatment for high-risk disease.


RESULTS
Multiple case series have recently been reported that demonstrate the long-term efficacy of radical prostatectomy in a high-risk population with 15-year prostate cancer-specific survival of over 80%. Comparisons of different treatment options using nonrandomized trials demonstrate improved outcomes with surgery compared with watchful waiting or radiation therapy.


CONCLUSIONS
Radical prostatectomy is an acceptable treatment alterative, which provides long-term durable disease control for men with high-risk prostate carcinoma.
Grubb
Robert L
RL
Division of Urology, Department of Surgery, Washington University in St. Louis, St. Louis, MO 63105, USA.
Kibel
Adam S
AS
D006801:Humans; D008297:Male; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000401:mortality / Q000601:surgery*; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome