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03-01-2024 | Prostate Cancer

Surgical Management and Considerations for Patients with Localized High-Risk Prostate Cancer

Authors: Andrew M. Fang, MD, Jamaal Jackson, MD, Justin R. Gregg, MD, Lisly Chery, MD, Chad Tang, MD, Devaki Shilpa Surasi, MBBS, CMQ, Bilal A. Siddiqui, MD, Soroush Rais-Bahrami, MD, MBA, Tharakeswara Bathala, MD, MBBS, Brian F. Chapin, MD

Published in: Current Treatment Options in Oncology | Issue 1/2024

Opinion statement

Localized high-risk (HR) prostate cancer (PCa) is a heterogenous disease state with a wide range of presentations and outcomes. Historically, non-surgical management with radiotherapy and androgen deprivation therapy was the treatment option of choice. However, surgical resection with radical prostatectomy (RP) and pelvic lymph node dissection (PLND) is increasingly utilized as a primary treatment modality for patients with HRPCa. Recent studies have demonstrated that surgery is an equivalent treatment option in select patients with the potential to avoid the side effects from androgen deprivation therapy and radiotherapy combined. Advances in imaging techniques and biomarkers have also improved staging and patient selection for surgical resection. Advances in robotic surgical technology grant surgeons various techniques to perform RP, even in patients with HR disease, which can reduce the morbidity of the procedure without sacrificing oncologic outcomes. Clinical trials are not only being performed to assess the safety and oncologic outcomes of these surgical techniques, but to also evaluate the role of surgical resection as a part of a multimodal treatment plan. Further research is needed to determine the ideal role of surgery to potentially provide a more personalized and tailored treatment plan for patients with localized HR PCa.

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Title: Surgical Management and Considerations for Patients with Localized High-Risk Prostate Cancer
Authors: Andrew M. Fang, MD
Jamaal Jackson, MD
Justin R. Gregg, MD
Lisly Chery, MD
Chad Tang, MD
Devaki Shilpa Surasi, MBBS, CMQ
Bilal A. Siddiqui, MD
Soroush Rais-Bahrami, MD, MBA
Tharakeswara Bathala, MD, MBBS
Brian F. Chapin, MD
Publication date: 03-01-2024
Publisher: Springer US
Keywords: Prostate Cancer
Prostate Cancer
Prostatectomy
Prostatectomy
Radiotherapy
Published in: Current Treatment Options in Oncology / Issue 1/2024
Print ISSN: 1527-2729
Electronic ISSN: 1534-6277
DOI: https://doi.org/10.1007/s11864-023-01162-4

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