title: Current role of surgery for high risk prostate cancer.
abstract: In this review, the role of surgery in patients with adverse tumor characteristics and a high risk of tumor progression are discussed. In the current PSA era the proportion of patients presenting with high risk prostate cancer (PCa) is estimated to be between 15% and 25% with a 10-year cancer specific survival in the range of 80-90% for those receiving active local treatment. The treatment of high risk prostate cancer is a contemporary challenge. Surgery in this group is gaining popularity since 10-year cancer specific survival data of over 90% has been described. Radical prostatectomy should be combined with extended lymphadenectomy. Adjuvant or salvage therapies may be needed in more than half of patients , guided by pathologic findings and postoperative PSA. Unfortunately there are no randomized controlled trials comparing radical prostatectomy to radiotherapy and no single treatment can be universally recommended. This group of high risk prostate cancer patients should be considered a multi-disciplinary challenge; however, for the properly selected patient, radical prostatectomy either as initial or as the only therapy can be considered an excellent treatment.
authors: Urology, Department of Development and Regeneration, University Hospitals of Leuven, 3000 Leuven, Belgium.
authors: Steven
authors: S
authors: Joniau
authors: Kathy
authors: K
authors: Van der Eeckt
authors: Alberto
authors: A
authors: Briganti
authors: Paolo
authors: P
authors: Gontero
authors: Siska
authors: S
authors: Van Bruwaene
authors: R
authors: R
authors: Jeffrey Karnes
authors: Martin
authors: M
authors: Spahn
authors: Hein
authors: H
authors: Van Poppel
mesh_terms: D006801:Humans; D008297:Male; D017430:Prostate-Specific Antigen; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery; D016879:Salvage Therapy
chemical_list: D017430:Prostate-Specific Antigen