Open AccessThe role of surgery in high risk and advanced prostate cancer: A narrative review
Author(s) -
Chloe Roy,
Ashwin Sachdeva,
G V Kandaswamy,
Bhavan Prasad
Publication year - 2021
Publication title -
turkish journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.347
H-Index - 8
eISSN - 2149-3057
pISSN - 2149-3235
DOI - 10.5152/tud.2020.20475
Subject(s) - prostate cancer , medicine , narrative , narrative review , cancer , prostate , general surgery , intensive care medicine , art , literature
Patients with high-risk and advanced prostate cancer require safe and efficacious therapies likely to offer a survival advantage while minimizing the treatment-related toxicities. Improvements in the surgical technology, diagnostic modalities, radiological staging, and risk stratification have made surgery for high-risk and advanced prostate cancer a safe and feasible option. In this review, we outline the role of radical prostatectomy in high-risk localized, locally advanced, and metastatic prostate cancer. We overview available data evaluating the use of surgery in the context of a multi-modal approach and highlight ongoing trials in this area. Furthermore, the role of surgery as a non-systemic modality for metastasis-directed therapy (MDT) is also described. Emerging imaging modalities enabling more accurate staging and longer follow-up of clinical trials for prognostic endpoints are anticipated to help identify patient cohorts and treatment strategies, where the use of surgical treatments is likely to provide oncological benefits and acceptable toxicity.