title: [High-risk prostate cancer. Review by the Oncology Committee of the French Urology Association].
abstract: BACKGROUND
  Localized prostate tumors have various clinical, biological and histopathological characteristics that lead to different progression profiles. High-risk prostate cancer has been classically defined by clinical examination, PSA levels and histopathological data. High-risk prostate cancer has usually a worse outcome, but classic stratification predictive of outcome for prostate cancer is a matter of debate concerning its accuracy.
  
  
  METHODS
  A systematic review of the literature on high-risk prostate cancer over the 15 last years was carried out on Medline database. The literature selection was based on evidence and practical considerations.
  
  
  RESULTS
  A great deal of scientific work have been deployed to prove that high-risk prostate cancer should be approached by teamwork including radio-hormone therapy, systemic treatment with long term use of LH-RH and a radical prostatectomy with adequate lymph node dissection. Selection of patients is essential to define individualized therapeutic strategy and timing for every modality should come as a consensus of medical supported evidence.
  
  
  CONCLUSIONS
  Accurate patient selection and multimodal treatment offer the best therapeutic option in high-risk prostate cancer.
authors: Institut Montsouris, université Paris-Descartes, France. francois.rozet@imm.fr
authors: F
authors: F
authors: Rozet
authors: C
authors: C
authors: Hennequin
authors: G
authors: G
authors: Fromont
authors: P
authors: P
authors: Mongiat-Artus
authors: C
authors: C
authors: Bastide
authors: P
authors: P
authors: Beuzeboc
authors: L
authors: L
authors: Cormier
authors: D
authors: D
authors: Eiss
authors: M
authors: M
authors: Peyromaure
authors: P
authors: P
authors: Richaud
authors: L
authors: L
authors: Salomon
authors: M
authors: M
authors: Soulié
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D019317:Evidence-Based Medicine; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D018579:Patient Selection; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D007987:Gonadotropin-Releasing Hormone; D017430:Prostate-Specific Antigen