title: The role for surgery in high-risk prostate cancer.
abstract: High-risk prostate cancer (PCa) refers to a very heterogeneous subgroup of disease. Recent series have shown very promising results of radical prostatectomy (RP)-alone or part as a multimodality approach-in patients with high-risk PCa, with satisfactory survival curves even though biochemical recurrence rate was high. Adjuvant treatment (radiotherapy (RT) alone or combined with androgen deprivation) was necessary in 20 to 54 % of patients, notably in cases with positive surgical margins. As for functional outcomes, urinary continence was preserved in about 92 % of cases and overall potency in 60 %. When comparing RP versus RT as primary treatment for high-risk PCa, a recent meta-analysis found surgery to be associated with an improved cancer-specific mortality compared with RT. In selected high-risk PCa young patients, surgery appears to be a valid option. Patients should however be informed of the possibility of adjuvant treatment, as part of a multimodal approach.
authors.affiliation: Academic Department of Urology, AP-HP, Hôpital Pitié-Salpétrière, 83 Bvd Hôpital, 75013, Paris, France.
authors.forename: Cécilia
authors.initials: C
authors.lastname: Lanchon
authors.affiliation: Department of Urology, Medical University of Vienna, Vienna, Austria.
authors.forename: Shahrokh
authors.initials: S
authors.lastname: F Shariat
authors.affiliation: Academic Department of Urology, AP-HP, Hôpital Pitié-Salpétrière, 83 Bvd Hôpital, 75013, Paris, France. mroupret@gmail.com.|UPMC Univ Paris 06, GRC5, ONCOTYPE-Uro, Institut Universitaire de Cancérologie, 75005, Paris, France. mroupret@gmail.com.
authors.forename: Morgan
authors.initials: M
authors.lastname: Rouprêt
mesh_terms: D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018450:Disease Progression; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D018714:Radiotherapy, Adjuvant; D012306:Risk; D015996:Survival Rate
keywords: High-risk Prostate cancer; Prognosis; Prostate cancer; Radical prostatectomy; Radiotherapy