[Can we improve the selection of patients for curative radical prostatectomy?]

The indication for curative radical prostatectomy in a patient with prostatic cancer clinically confined to the prostate (stage T1, T2) and the absence of any detectable metastases, is associated with a postoperative recurrence rate of 24 to 51% after a mean follow-up of 3 years. Certain preoperative criteria allow the selection of patient groups in which the risk of postoperative tumour recurrence is higher: presence of more than 4 positive biopsies out of 6 systematized biopsies associated with a Gleason score greater than or equal to 7 and a PSA higher than 15 ng/ml (normal value for monoclonal test < 4 ng/ml). The indication for curative radical prostatectomy is doubtful in this group of patients.