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Radical prostatectomy for locally advanced prostate cancer
Younger men with no or few comorbidities and long life expectancies are the best candidates for surgery for locally advanced disease, assuming that on rectal exam and imaging studies that the prostate looks removable – older patients, those with significant comorbidities, and those patients who have truly bulky tumors that invade surrounding organs or extend to the pelvic sidewall are best treated with radiation and hormones. The main message form this study is that in select patients and experienced surgical hands radical prostatectomy offers a safe and feasible alternative to radiation therapy, avoids the use of hormone therapy and its side effects, and may carry a lower chance of local recurrence. Combinations of surgery and chemotherapy before and/or after surgery are currently in clinical trials – these combos are feasible and may be the next step in advancing the rate of cure.
Bibliographic reference:
Eric Klein Section of Urologic Oncology, Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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