Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
Prostate Int. 2013;1(3):95-101. doi: 10.12954/PI.13018. Epub 2013 Sep 27.
Because of the increase in prostate cancer patients, urologists can detect more clinically localized prostate cancer in patients before the disease has progressed to advanced stages. Nevertheless, some patients are still diagnosed with high-risk prostate cancer. Even though several treatment options are available for high-risk prostate cancer patients, including radical prostatectomy, radiotherapy, and hormone therapy, used alone or in combination, the recurrence rate is high regardless of the type of treatment. Nevertheless, in the experience of many urologists, a substantial proportion of high-risk prostate cancer patients are cured by local definite therapy or multimodality treatment. Thus, several treatment combinations have been attempted as treatments in these patients. Among them, radical prostatectomy is regarded as the first step in high-risk prostate cancer patients, on a selective basis. In some high-risk prostate cancer patients, surgery is a one-step modality in treatment and has an excellent oncological prognosis. However, because of the lack of evidence and well-controlled comparative prospective studies, the best course of treatment can be unclear, and oncological outcomes often appear heterogeneous. We therefore review the current literature on clinical outcomes in high-risk prostate cancer.
由于前列腺癌患者的增加，泌尿科医生可以在疾病进展到晚期之前，在患者中发现更多临床局限性的前列腺癌。然而，仍有一些患者被诊断为高危前列腺癌。尽管高危前列腺癌患者有多种治疗选择，包括根治性前列腺切除术、放疗和激素治疗，单独或联合使用，无论哪种治疗方式，复发率都很高。然而，在许多泌尿科医生的经验中，相当一部分高危前列腺癌患者通过局部确定性治疗或多模态治疗被治愈。因此，针对这些患者尝试了多种治疗组合。其中，根治性前列腺切除术被认为是高危前列腺癌患者的首选治疗方法，这是有选择性的。在一些高危前列腺癌患者中，手术是治疗的一种单一模式，具有极好的肿瘤学预后。然而，由于缺乏证据和经过良好控制的前瞻性对照研究，最佳治疗方案可能并不明确，肿瘤学结果往往表现出异质性。因此，我们回顾了高危前列腺癌的临床结果的现有文献。
