title: [Preoperative assessment of patient candidate to prostate cancer surgery].
abstract: OBJECTIVE
  To determine the tools of therapeutic decision that push towards surgical treatment in non metastatic prostate cancer eligible to local treatment. The optimized assessment of the disease and eventual comorbidities improves the selection of patients. Patient's files will be presented in the uro-oncological multidisciplinary discussions to validate the customized therapeutic approach proposed.
  
  
  METHODS
  Literature review using Medline (National library of medicine, Pubmed) and Med Science databases based on the scientific pertinence. Research was focused on the diagnosis of prostate cancer, the evaluation of the disease and patient's characteristics, and finally the elements that are with a surgical treatment (past medical history, past surgical history, functional status, patient's comorbidities, and life expectancy).
  
  
  RESULTS
  The pretherapeutic oncologic evaluation allows to estimate the risks associated with prostate cancer; it is an essential aspect of therapeutic decision. Several clinical, biological, imaging and pathological criteria allow to guide decision-making according to tumor aggressiveness and risk of recurrence, estimating the results of the different treatments proposed. On the other hand, the evaluation of lower urinary tract symptoms, urinary continence and sexual function, the integration of anatomical data, past medical and past surgical history are all essential for the therapeutic decision, in addition to the comorbidities (Charlson, ASA, ICD). These elements should be taken all together in order to decide for a radical or conservative management of PCa, they guide decision-making in patients candidate for surgery. For example, age plays a key role in the choice of treatment, even in older men at risk of developing high-risk PCa that can affect overall survival.
  
  
  CONCLUSIONS
  The combined evaluation of the patient and disease characteristics is of utmost importance in oncology, and especially in the treatment of non-metastatic PCa. The role of the anesthesiologist in the analysis and interpretation of comorbidities remains primordial and it is essential for the selection of the right candidates for surgery after being well informed, and orienting them toward surgery in agreement with the prerogatives programs of customized care.
authors.affiliation: Département d'urologie-andrologie-transplantation rénale, CHU Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse cedex 9, France.
authors.forename: J-B
authors.initials: JB
authors.lastname: Beauval
authors.affiliation: Département d'anesthésie-réanimation, CHU Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Mazerolles
authors.affiliation: Service d'urologie et de transplantation rénale et pancréatique, CHU Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Salomon
authors.affiliation: Département d'urologie-andrologie-transplantation rénale, CHU Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse cedex 9, France. Electronic address: soulie.m@chu-toulouse.fr.
authors.forename: M
authors.initials: M
authors.lastname: Soulié
mesh_terms: D006801:Humans; D008297:Male; D011300:Preoperative Care; D011379:Prognosis; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000601:surgery*; D018570:Risk Assessment
keywords: Anesthesiology; Anesthésiologie; Biomarkers; Biomarqueurs; Biopsies prostatiques; Cancer de la prostate; Comorbidity; Décision thérapeutique; Erection; Imagerie; Imaging; Micturition; Preoperative assessment; Prostate biopsy; Prostate cancer; Prostatectomie totale; Radical prostatectomy; Scores de comorbidité; Statut mictionnel; Therapeutic management; Érection