Adjuvant Treatment for High-Risk Operable Prostate Cancer

Patients who have undergone a radical prostatectomy may have to face high risks of recurrence. The risk of recurrence is elevated due to probable occult metastatic disease at the time of diagnosis. A rationale for using multimodal approach in order to minimize the chance of disease recurrence and to improve the survival of high risk patients is emerging from preclinical and clinical studies. New molecular and genetics assays, may help to select patients most likely to benefit from these approaches. In this review, we will especially discuss the potential benefits of adjuvant therapy after radical prostatectomy. This paper presents the identification of these high-risk patients; the explanation of an adjuvant treatment of residual disease after a radical prostatectomy; the clinical studies with adjuvant androgen deprivation, radiotherapy and/or chemotherapy and the microarrays analysis. This review highlights the importance of these new adjuvant treatments that aims at targeting the factor which triggers metastatic disease following a radical prostatectomy.