The role for surgeryin high-risk prostate cancer

Abstract

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.

High expression of Rab25 contributes to malignant phenotypes and biochemical recurrence in patients with prostate cancer after radical prostatectomy

“…Statistically, there are more than 200,000 newly diagnosed cases with PCa annually throughout the world [2]. Although a number of PCa patients can be diagnosed at an early stage and low-risk disease may exert no impact on patients’ life expectancy, it is a great challenge to develop effective strategies to treat metastasis and biochemical recurrence of PCa which cannot be treated by surgery or adjuvant therapies [3].…”