Treatment strategies for locally advanced prostate cancer.

With the increasing aged population, prostate cancer has become one of the commonest malignant tumors in the United States. The incidence of prostate cancer is the highest among malignant tumors in males, and the mortality rate is the second highest following lung cancer. Even when prostate cancer is diagnosed to be in the early stage preoperatively, its excised lesions are often judged pathohistologically to be locally advanced tumor (staging error). Therefore, to estimate the exact pathological stage of excised lesions by preoperative parameters such as clinical T, PSA and biopsy Gleason Score, Partin's nomogram is generally used in the United States. However, according to the annual update version of the 2001 millennium update, radical prostatectomy should not be applied to T3, and it was excluded from the nomogram. Currently, the standard methods for the treatment of locally advanced prostate cancer may be external beam radiotherapy and brachytherapy with neoadjuvant hormonal therapy and intraprostate 125I and 103Pd seeds with neoadjuvant hormonal therapy, although the long-term results are unknown. In our study, similar to a report by Messing et al., adjuvant hormonal therapy might be effective in patients in whom the tumor was diagnosed as being in the early stage but was later found to be N (+) after its operation.