Radical prostatectomy: Expanding role in the management of patients with adenocarcinoma of the prostate

In summary, because of recent advances in surgical technique, radical prostatectomy has become more widely accepted as a therapy for prostate cancer. We believe it is the best therapy for prostate cancer that is pathologically confined to the prostate because total tumor removal can be accomplished with low morbidity. In addition, in select patients with more advanced disease, radical prostatectomy, while not curative, provides excellent palliation of the local lesion with minimal morbidity. We currently perform radical prostatectomy in patients with stage A and B disease with curative intent and as excellent palliation in some men with stage C and D1 prostate cancer. Future areas of research include the identification of factors that will more accurately predict tumor aggressiveness and metastatic potential, improved staging of prostate cancer, and most importantly, development of adjuvant chemotherapy for advanced disease.