Optimal treatment of locally advanced prostate cancer.

Abstract:

:The treatment of clinically locally advanced prostate cancer (cT3-4) is subject to controversies. Patients with lymph node metastases as well as patients with overstaged localized and thus curable disease fall into this category. Radical prostatectomy, external beam radiotherapy and early or deferred hormonal therapy are possible treatment options. Multimodal treatment (i.e., a combination of these options) is frequently used. After radical prostatectomy, Gleason score-adjusted disease-specific survival does not differ meaningfully between the tumor stages pT2 and pT3-4. In the case of lymph node metastases after radical prostatectomy, but not in node-negative disease, adjuvant hormonal treatment seems to improve survival. Adjuvant radiotherapy may improve biochemical and local control in locally advanced prostate cancer, a survival benefit has, however, not yet been proven. External beam radiotherapy alone provides unfavourable survival rates in locally advanced prostate cancer. Adjuvant hormonal treatment may improve outcome in this setting. When no curative treatment is chosen, early hormonal treatment seems to provide modest benefit compared with deferred therapy.

journal_name

World J Urol

journal_title

World journal of urology

authors

Wirth MP,Hakenberg OW,Froehner M

doi

10.1007/s00345-007-0158-7

subject

Has Abstract

pub_date

2007-04-01 00:00:00

pages

169-76

issue

2

eissn

0724-4983

issn

1433-8726

journal_volume

25

pub_type

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