Radical prostatectomy in the management of clinically localized prostate cancer.

BACKGROUND Several management options are available when prostate cancer is diagnosed at an early stage. However, the optimal treatment for localized prostate cancer is unknown, and reports in the literature are controversial regarding the best treatment modality for this early presentation. METHODS The authors review improvements in surgical technique that have decreased complications, and they address long-term outcomes of surgery related to cancer control. RESULTS Improvements in surgical techniques allow for decreased intraoperative complications. The incidence of long-term complications such as incontinence and impotency is also reduced. The 5- and 10-year progression-free survival with radical prostatectomy has improved. CONCLUSIONS Surgery today is safer with improvements in techniques. The long-term outcomes with surgery are excellent and, in several series, better than outcomes achieved with other treatment modalities.