Identifying the relevant population for neoadjuvant chemo-hormonal therapy combined with radical prostatectomy

High-risk localized PCa account for about 15% of cases at diagnosis (1) and it is particularly important to establish an appropriate treatment strategy for these patients, considering a multimodal approach and including both local and systemic therapies. Radical prostatectomy (RP) may be an option for selected patients with high-risk localized prostate cancer with an acceptable cancer-specific mortality (10–15%) at 10 years; however, oncological outcomes are decreasing for the subgroups of highest risk patients who have ≥ pT3 disease, Gleason score ≥8, and lymph node invasion. For these patients, the risk of recurrence is up to 70% at 10 years after RP (2).