title: Multimodal approaches to high-risk prostate cancer.
abstract: Widespread use of testing for prostate-specific antigen (PSA) has led to a migration in the stage and grade of prostate cancer (PCa), with most men presenting with localized disease. However, 20%-35% of patients still present with high-risk disease (PSA > 20 ng/mL, biopsy Gleason score 8-10, or clinical stage T3). Despite advances in various treatment modalities, patients with high-risk disease have a significant chance of recurrence and death after surgery, often because of the presence of early occult metastasis at time of diagnosis. The optimal management of high-risk pca remains controversial. The present article aims to discuss the traditional approaches and the more recent evolution toward multimodal therapies.
authors.affiliation: The Vancouver Prostate Centre and Department of Urological Sciences, University of British Columbia, Vancouver, BC. anthonykoupparis@googlemail.com
authors.forename: A
authors.initials: A
authors.lastname: Koupparis
authors.forename: M E
authors.initials: ME
authors.lastname: Gleave