ABSTRACT

Locally advanced prostate cancer is defined as cancer that has extended clinically beyond the prostatic capsule with invasion of the pericapsular tissue, the sphincter muscle, bladder neck, or seminal vesicles, without lymph node involvement or distant metastases. Locally advanced prostate cancer is referred to as clinical stage T3-T4 N0 M0 disease. High-risk prostate cancer represents a therapeutic challenge. The role of surgery in clinical stage T3 prostate cancer is still subject to debate. Although radical prostatectomy might be inadequate as a solitary therapeutic approach for high risk prostate cancer in a subset of patients, the procedure allows surgical control with good quality of life and satisfying functional outcome. Accurate pathologic information and improved patient selection for individual adjuvant treatment is possible. In T3 prostate cancer, radical prostatectomy is technically feasible with morbidity comparable to radical prostatectomy in clinically localized prostate cancer.