title: [Multimodal therapy of locally advanced prostate cancer].
abstract: Locally advanced prostate cancer (LAPCA) comprises about 5-10 % of all newly diagnosed prostate cancers and is associated with the highest prostate cancer specific mortality (approximately 8-20 %). LAPCA is defined by the presence of extraprostatic extension, seminal vesicle invasion, and bladder neck infiltration of pelvic lymph node metastases. It is evident that prognosis can only be improved by interdisciplinary multimodality treatment strategies. Adequate local staging by multiparametric MRI is one of the cornerstones for an individualized, risk-adapted treatment approach. This might consist of extended radical prostatectomy with an extended pelvic lymphadenectomy or intensity-modulated radiation therapy with androgen deprivation as the primary local therapeutic approach. Both treatment strategies may be combined with neoadjuvant or adjuvant radiation therapy or salvage surgery. Combination with neoadjuvant or adjuvant chemotherapy and new androgen receptor pathway inhibitors might also be possible. This article summarizes the current treatment strategies for LAPCA.
authors.affiliation: Klinik für Urologie, Universitätsklinikum Köln, Kerpener Str. 62, 50937, Köln, Deutschland. axel.heidenreich@uk-koeln.de.
authors.forename: A
authors.initials: A
authors.lastname: Heidenreich
authors.affiliation: Klinik für Radioonkologie und Strahlentherapie, Charité Campus Benjamin Franklin, Berlin, Deutschland.
authors.forename: D
authors.initials: D
authors.lastname: Böhmer
mesh_terms: D059248:Chemoradiotherapy / Q000009:adverse effects / Q000592:standards*; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000592:standards; 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*; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Androgen antagonists; Lymphadenectomy; Prostatectomy; Radiation therapy