Radical surgery for prostatic cancer

Radical surgical procedures for the cure of prostatic cancer are based on the premise that all cancer cells reside in the tissue to be excised and that the excision be properly accomplished. In the 75 years that have elapsed since radical prostatectomy was first performed, the criteria for the selection of surgical candidates have been refined. Based on pathologic findings and demonstrated long-term tumor-free survival, those patients apt to derive the greatest benefit from radical surgery are those with Stage B₁ lesions. We were able to trace 57 patients with Stage B₁ disease who underwent radical perineal prostatectomy at The Johns Hopkins Hospital between the years 1951-1963. Fifteen years or more postoperatively, 29 (51%) were alive and well, 10 (17%) died of recurrent cancer, and 18 (32%) died without disease. There are no available data to prove that any other therapeutic modality can match the 15-year survival provided by radical prostatectomy in patients with this stage of disease.