Role of Surgery in Treatment of Locally Advanced Prostate Cancer

The proportion of prostate cancer diagnosed at localized stages increased from 56.7% to 74.0% between 1973 and 1993 (“stage migration”). A corresponding increase in the number of radical prostatectomies performed each year was also noted. Nomograms are mathematical algorithms derived from statis...

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Bibliographic Details
Published in:Anticancer research 2006-07, Vol.26 (4B), p.3151-3158
Main Authors: PREZIOSO, Domenico, GALASSO, Raffaele, DI MARTINO, Mario, IAPICCA, Gennaro, IACONO, Fabrizio
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Humans
Male
Medical sciences
Middle Aged
Neoplasm Staging
Nephrology. Urinary tract diseases
Prostatectomy
Prostatic Neoplasms - pathology
Prostatic Neoplasms - surgery
Treatment Outcome
Tumors
Tumors of the urinary system
Urinary tract. Prostate gland
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Summary:The proportion of prostate cancer diagnosed at localized stages increased from 56.7% to 74.0% between 1973 and 1993 (“stage migration”). A corresponding increase in the number of radical prostatectomies performed each year was also noted. Nomograms are mathematical algorithms derived from statistical models that are used to predict outcomes for an individual patient, or for groups of patients. In fact, careful pre-operative patient and tumor selection before radical prostatectomy is mandatory. Locally advanced prostate cancer is defined as tumor that has extended clinically beyond the prostatic capsule, with invasion of the pericapsular tissue, apex, bladder neck or seminal vescicle, but without lymph node involvement or distant metastasis. It is estimated that 12-15% of prostate cancer are stage T3. Overstaging or understaging of this cancer is common. Correct staging of clinical T3 disease is even more difficult and both overstaging pT2 and understaging pT4 or pN+ are common. The goals of treatment for T3 tumors are to cure the disease, prolong survival or metastasis-free survival and improve the quality of life. The authors reviewed the most important studies, investigated radical prostatectomy as monotherapy for locally advanced prostate cancer and the integration of surgery with hormonal treatment. The EAU guidelines on prostate cancer state that radical prostatectomy in locally advanced disease is an option for selected patients with small T3, PSA
ISSN:0250-7005
1791-7530