Urologia Internationalis

Review

Treatment of Locally Advanced Prostate Cancer – The Case for Radical Prostatectomy

Hakenberg O.W. · Fröhner M. · Wirth M.P.

Author affiliations

Klinik und Poliklinik für Urologie, Universitätsklinikum ‘Carl Gustav Carus’ der Technischen Universität Dresden, Dresden, Germany

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Urol Int 2006;77:193–199
https://doi.org/10.1159/000094808

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Article / Publication Details

First-Page Preview
Abstract of Review

Received: April 25, 2006
Accepted: April 25, 2006
Published online: October 11, 2006
Issue release date: October 2006

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 1

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN

Abstract

The treatment of clinically locally advanced prostate carcinoma (stage cT3) remains controversial. One of the main reasons for this controversy results from the substantial staging error attached to the clinical diagnosis cT3 with overstaged T2 tumors and understaged node-positive cases. Treatment options in this situation include radical prostatectomy, external beam radiotherapy, immediate or delayed androgen deprivation treatment and the so-called ‘watchful waiting’. Acceptable and often surprisingly good tumor-specific survival rates have been reported for radical prostatectomy in pT3 series – based on good clinical case selection – approaching those of pT2 series. In lymph node-positive pT3 cases, adjuvant hormone deprivation seems to prolong survival which it does not in lymph node-negative pT3 disease. A benefit of adjuvant external beam radiotherapy after radical prostatectomy for pT3 cases in prolonging overall survival has not been shown, despite the fact that it can prevent or delay biochemical and local recurrence. External beam radiotherapy as the only treatment for cT3 disease results in unfavorable tumor-specific survival rates, which can be significantly improved with adjuvant hormonal treatment with LHRH agonists. If, in case of advanced age and/or significant comorbidity, primary hormonal treatment is chosen, early hormonal deprivation therapy seems to offer marginal benefits in survival compared to delayed treatment.

© 2006 S. Karger AG, Basel



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Article / Publication Details

First-Page Preview
Abstract of Review

Received: April 25, 2006
Accepted: April 25, 2006
Published online: October 11, 2006
Issue release date: October 2006

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 1

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN

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2006, Vol.77, No. 3

October 2006

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