[Prostatectomy for prostate cancers]

Radical prostatectomy may afford cure in men in whom the malignancy is completely extirpable. Historical experiences as well as ours agreed that long term survival after radical prostatectomy was excellent if the disease was confined to the organ. Cure may also be expected in some selected patients with minimal extra-organ invasion. Furthermore, preoperative hormonal therapy may improve the cure rate in these invasive diseases. However, if cure means affording the patient the best chance of dying of some causes other than cancer, some of those extirpable diseases may be cured without surgery. This idea was supported by epidemiologic data on the natural history of the disease, and retrospective observations of conservatively treated patients. Challenging issues toward the 21st century are to expand the range of surgically curative diseases, and to identify diseases extirpable but predestined never to kill the host during the natural course of his life.