title: [Localized intermediate- to high-risk prostate cancer].
abstract: BACKGROUND
  National and international guidelines recommend radical prostatectomy (RP) and radiotherapy (EBRT) as standard treatment for intermediate- and high-risk prostate cancer. Survival benefit of RP in prostate cancer has been proven in prospectively randomized trials. In contrast, the benefit of EBRT as well as the direct comparison of EBRT and RP have been investigated in several retrospective analyses, but are limited by typical problems associated with retrospective studies.
  
  
  RESULTS
  Most of the studies comparing RP with EBRT favor RP with regard to overall survival and cancer-specific survival. Especially in young patients with high-grade prostate cancer, RP seems to be superior in comparison with EBRT. These patient are at high risk of a PSA recurrence and subsequently need an additional radiotherapy. Mortality and morbidity related to these both methods are low. Main complications of RP are urinary incontinence and erectile dysfunction. In contrast, rectal sequelae, erectile dysfunction, and irritative urinary symptoms are the main cause for postinterventional morbidity in patients after EBRT.
authors.affiliation: Urologische Klinik und Poliklinik, Klinikum Großhadern der LMU, Marchioninistr. 15, 81377, München, Deutschland. stefan.tritschler@med.uni-munchen.de.
authors.forename: S
authors.initials: S
authors.lastname: Tritschler
authors.affiliation: Klinik und Poliklinik für Strahlentherapie und Radioonkologie der LMU, Klinikum Großhadern, München, Deutschland.
authors.forename: U
authors.initials: U
authors.lastname: Ganswindt
authors.affiliation: Urologische Klinik und Poliklinik, Klinikum Großhadern der LMU, Marchioninistr. 15, 81377, München, Deutschland.
authors.forename: C G
authors.initials: CG
authors.lastname: Stief
mesh_terms: D019317:Evidence-Based Medicine; D005858:Germany; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000592:standards*; D009367:Neoplasm Staging; D017410:Practice Guidelines as Topic; D011468:Prostatectomy / Q000009:adverse effects / Q000592:standards*; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000628:therapy*; D011878:Radiotherapy / Q000009:adverse effects / Q000592:standards*; D012307:Risk Factors; D016896:Treatment Outcome
keywords: External beam radiation therapy; Morbidity; Mortality; Radical prostatectomy; Radiotherapy