In the Netherlands 16% of all newly diagnosed @entity263 are already locally advanced ( @entity2802 -system: T3), which means that the @entity5 spreads beyond the prostatic capsule, or grows into the seminal vesicles. The pre-operative clinical staging is not very reliable when local @entity5 extension is concerned: the sensitivity for detecting extracapsular extension is 67% for digital rectal examination and 58% for transrectal ultrasonography of the prostate. In 50% of clinically locally confined @entity5 spread outside the prostate is found; and in 18% of the T3 @entity5 the @entity5 is confined to the prostate. In most clinics @entity1 with locally advanced @entity5 are not considered to be candidates for radical prostatectomy, because the margins are small, due to anatomical factors. Progression and survival reported in the research literature for @entity1 treated by radical prostatectomy for @entity263 are, however, at least equal to those treated with radiotherapy, which is considered the standard treatment for this stage. The average 10-year percentages for progression and survival of @entity263 @entity1 treated by radical prostatectomy (or radiotherapy) are: clinical progression: 40% (radiotherapy: 61%); local recurrence 18% (35%); biochemical progression: 60% (93%); survival: 63% (39%); and @entity263 specific survival: 78% (44%). These success-rates can not be compared directly, because of differences in physical condition and staging between the groups, which favor the radical prostatectomy group. There is, however, a subgroup of @entity1 with @entity189 which shows high progression rates following radical prostatectomy; these @entity1 need adjuvant hormonal treatment, or should be given a different therapy. The role of adjuvant radiotherapy following radical prostatectomy is still a matter of debate, as is the administration of neoadjuvant hormonal therapy. For the moment these therapies should only be given in clinical trials.

[The treatment of locally advanced (T3) XXXX using radical prostatectomy or radiotherapy. A review].

@entity1 :: ('9606', 'Species') :: ['patients'] @entity263 :: ('MESH:D011471', 'Disease') :: ['prostate cancer', 'prostatic carcinomas', 'T3 prostate cancer'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'tumors'] @entity189 :: ('MESH:D002277', 'Disease') :: ['undifferentiated carcinoma'] @entity2802 :: ('10178', 'Gene') :: ['TNM']
@entity263 :: (MESH:D011471,Disease) :: ['prostatic carcinoma']
