Radical Prostatectomy: An Option for High-Risk Prostate Cancer

. High-risk prostate cancer represents a therapeutic challenge. The role of radical prostatectomy (RP) in patients with extreme PSA values is under discussion. Material and Methods . We retrospectively analysed our data of 56 consecutive patients with preoperative PSA ≥ 40 mg/mL undergoing open radical retropubic prostatectomy from 1999 to 2009. Patient survival and time to PSA recurrence were recorded, and the Kaplan-Meier survival analysis was performed. Postoperative quality of life and functional status were investigated using a SF-12 questionnaire and determining the number of pads used per day. Results . Overall 56 patients were available for followup after a median time of 83.84 months. Locally advanced carcinoma was present in 84% while 16% of patients had organ-confined stages. A positive nodal status was observed in 46%. Overall survival was 95% at five and 81% at 10 years. Cancer-specific survival was 100% for five years and 83% for 10 years. Corresponding biochemical recurrence-free survival was low (52% and 11%, resp.). Quality of life and functional outcomes were favourable. Conclusions . In patients with PSA ≥ 40 mg/mL, RP allows long-term control, exact planning of adjuvant treatment, and identification of curable disease.