[Status and trends of curative therapeutic procedures in localized prostate cancer]

The first 10-year-treatment results may allow an assessment of various therapeutic methods of localized prostatic carcinoma at which the question of survival rate and the spectrum of complications take as a basis. In localized prostatic carcinoma the individual character of curative therapeutic regimens has been increased. The new UICC classification come up to this development. The radical operation is the standard method in the treatment of curable cancer (T1-T2) with most superior survival rates. A safe intraoperative bladder-urethra anastomosis and the postoperatively possible urethrotomia interna may reduce urinary incontinence and stenosis of the anastomosis. The use of erectile-protective PE-technique should be verified with regard to its radicality. The interstitial radiation therapy using J 125 seeds or Iridium 192 is of superior therapeutic value. Whether the perineal ultrasound-guided implantation of J 125 or Ir 192 are advantageous should be checked by further investigation. A benefit from this method is its safe of potency; it may be used in cancer with low grading and tumor stage, but a close urological-radiological co-operation, a special equipment and radiation protection measures are necessary. Radiation therapy is indicated in older patients with localized tumors (T1-T3), but further reduction of irradiation side-effects and a biological judgement of the tumor by posttherapeutic biopsies be required. Since the prognosis of the prostatic cancer patients is dependent on lymphogenous metastatic spread its determination should be demand prior to localized therapy. In radical prostatectomy the pelvic lymph node dissection is performed simultaneously.(ABSTRACT TRUNCATED AT 250 WORDS)