[Radical surgery of locally advanced prostatic cancer]

Retrospective study in 51 patient with locally advanced prostate cancer (34 pT3 and 17 N+) selected from 88 radical prostatectomies performed between February 1985 and December 1993. An evaluation is made of the clinical/pathological stage correlation and the effectiveness of the different diagnostic methods (61% of understaging). The possibility to rescue locally spread tumours is analyzed, 7/51 (13.72%) patients receiving pre-operative neoadjuvant hormonal therapy. Estimated survival at 8 years was 82.6% of all patients treated with radical surgery and, at the end of the study, the situation of 30/46 (65.2%) patients assessed by digital rectal examination, quality of life index, PSA follow-up, abdominal ultrasound and/or CT, bone scan and chest X-ray, was an estimated 8-year disease-free evolution. It is observed that radical surgery and the post-surgical hormonal approach permit good survival in locally advanced prostate cancer and that the use of a neoadjuvant hormonal approach permit good survival in locally advanced prostate cancer and that the use of a neoadjuvant hormonal approach allows in many cases the rescue of patients for radical surgery.