INTRODUCTION: Radical prostatectomy (RP) in patients with locally advanced (cT3) prostate cancer (PCa) is considered an optional therapy. AIM: To evaluate outcomes of surgery for cT3 disease and to compare results with those of patients treated for cT1-T2 PCa. PATIENTS AND METHODS: Data of 74 consecutive patients with cT3 N0M0 PCa who underwent RP were compared to those of 425 consecutive unselected patients who underwent surgery for cT1-T2 N0M0 disease. RESULTS: cT3: The pathological report showed a pathological downstaging in 16.3% of cases. Continence rate was 65.5%, potency rate was 38.8%, 5-year PSA-free survival was 61.9%, 5-year cancer-specific survival was 95.2%. cT1-T2: The pathological report showed a clinical downstaging in 39.1%. Continence rate was 70.8%, potency rate was 56.2%, 5-year PSA-free survival was 67.4%, 5-year cancer-specific survival was 96.0%. CONCLUSIONS: cT3 PCa presents challenges for the uro-oncologist since standard treatment is still under debate. RP in well-informed patients is a procedure with acceptable morbidity and should be at least a first part of a multimodality approach.
INTRODUCTION: Radical prostatectomy (RP) in patients with locally advanced (cT3) prostate cancer (PCa) is considered an optional therapy. AIM: To evaluate outcomes of surgery for cT3 disease and to compare results with those of patients treated for cT1-T2 PCa. PATIENTS AND METHODS: Data of 74 consecutive patients with cT3 N0M0 PCa who underwent RP were compared to those of 425 consecutive unselected patients who underwent surgery for cT1-T2 N0M0 disease. RESULTS:cT3: The pathological report showed a pathological downstaging in 16.3% of cases. Continence rate was 65.5%, potency rate was 38.8%, 5-year PSA-free survival was 61.9%, 5-year cancer-specific survival was 95.2%. cT1-T2: The pathological report showed a clinical downstaging in 39.1%. Continence rate was 70.8%, potency rate was 56.2%, 5-year PSA-free survival was 67.4%, 5-year cancer-specific survival was 96.0%. CONCLUSIONS:cT3 PCa presents challenges for the uro-oncologist since standard treatment is still under debate. RP in well-informed patients is a procedure with acceptable morbidity and should be at least a first part of a multimodality approach.