Treatment of Patients With High Risk Prostate Cancer

ABSTRACT

The Korean Urological Oncology Society has developed a guideline for treatment of prostate cancer by adapting various prostate cancer guidelines in a systematic manner in order to create a guideline that reflects the real practice in Korea. In this article, 5 key questions for treatment of the patients with high risk prostate cancer were suggested, and the answers were presented. Active surveillance in patients with high risk prostate cancer is not recommended. External radiotherapy combined prolonged androgen deprivation therapy are recommended rather than external radiation therapy alone for them. Extended pelvic lymphadenectomy could be considered since it provides information of accurate staging, however, it is questionable that extended pelvic lymphadenectomy increases the survival rate of high-risk prostate cancer patients. Both postoperative adjuvant radiotherapy and salvage radiotherapy can be considered when adverse pathologic features are found after radical prostatectomy. If lymph node metastasis is confirmed after radical prostatectomy with pelvic lymphadenectomy, adjuvant androgen deprivation therapy is recommended.