prostate-report.org

European management of T3 prostate cancer

The gold standard treatment for clinical stage T3 prostate cancer has long been the combination of radiotherapy and extended hormone therapy. However, the accuracy of clinical staging based on DRE is open to some question, since 20 percent of patients assessed to have cT3 prostate cancer today appear to be over-staged during physical examination.

A recent study has reviewed available data on the surgical management of cT3 prostate cancer and compared the available data to the current European guidelines.

The authors state that, with respect to adverse effects of treatment, urinary continence outcomes are comparable to those following prostatectomy for localized prostate cancerand rates of  erectile dysfunction correlate with the type of surgery. They suggest that there appears to be no impact on overall or prostate cancer-specific survival of neoadjuvant treatments.

Autors conclude that radical prostatectomy can now be considered  as a viable, alternative, first-line treatment option for carefully evaluated patients with cT3 disease. They add, however, that patients should be cautioned about the potential need for adjuvant therapies during the postoperative course of their disease. They also comment that the potential value of early adjuvant radiation therapy (as compared to salvage radiation) is still not fully resolved.