Current role of surgery for high risk prostate cancer

Steven Joniau, Kathy Van Der Eeckt, Alberto Briganti, Paolo Gontero, Siska Van Bruwaene, R. Jeffrey Karnes, Martin Spahn, Hein Van Poppel

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


In this review, the role of surgery in patients with adverse tumor characteristics and a high risk of tumor progression are discussed. In the current PSA era the proportion of patients presenting with high risk prostate cancer (PCa) is estimated to be between 15% and 25% with a 10-year cancer specific survival in the range of 80-90% for those receiving active local treatment. The treatment of high risk prostate cancer is a contemporary challenge. Surgery in this group is gaining popularity since 10-year cancer specific survival data of over 90% has been described. Radical prostatectomy should be combined with extended lymphadenectomy. Adjuvant or salvage therapies may be needed in more than half of patients, guided by pathologic findings and postoperative PSA. Unfortunately there are no randomized controlled trials comparing radical prostatectomy to radiotherapy and no single treatment can be universally recommended. This group of high risk prostate cancer patients should be considered a multi-disciplinary challenge; however, for the properly selected patient, radical prostatectomy either as initial or as the only therapy can be considered an excellent treatment.

Original languageEnglish (US)
Pages (from-to)259-273
Number of pages15
JournalArchivos espanoles de urologia
Issue number3
StatePublished - Apr 2013


  • Adjuvant treatment
  • Extended lymphadenectomy
  • High-risk prostate cancer
  • Multimodality approach
  • Radical prostatectomy
  • Salvage treatment

ASJC Scopus subject areas

  • Medicine(all)


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