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01.10.2015 | main topic | Ausgabe 19-20/2015

Wiener Medizinische Wochenschrift 19-20/2015

The role for surgeryin high-risk prostate cancer

Wiener Medizinische Wochenschrift > Ausgabe 19-20/2015
Cécilia Lanchon, Shahrokh F. Shariat, MD, PhD Morgan Rouprêt


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.

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