Indications for radical prostatectomy in localized cancer of the prostate

The exceptional character of the natural history of prostate cancer continues to feed the controversy about the indication of radical prostatectomy in localised prostatic cancer. However, the correlation between tumor volume and the risk of disease progression established by recent pathological studies seems to demonstrate an ideal indication for radical prostatectomy for a tumor volume between 0.5 and 4 cc. However the precise estimation of this tumor volume by current diagnostic tools is still insufficient. Nevertheless, recent publications show that radical prostatectomy, whose complications must not be overestimated, gives real chances of obtaining good local control of the disease, even for advanced localised cancers. This operation can be rationally proposed to people with a sufficiently long life expectancy.