In the last years radical retropubic prostatectomy has become the trea
tment of choice for locally confined prostate cancer (PCa). However, i
n the literature local recurrence is described in 4-23 % of patients w
ith clinical stage T1-2 prostate cancer and in 43 % of patients with c
linical stage T3 respectively. The problem is further aggravated that
postoperatively raised PSA values are detected in 6-8 % of patients wi
th locally confined prostate cancer indicating either local residual t
umor or systemic disease. Current datas show that wait-and-watch appea
rs to be the best option for patients with locally confined prostate c
ancer and positive margins. In case of persistent or raising PSA-value
s following prostatectomy without detectable local recurrence or metas
tasis mere local therapy cannot be recommended. Primary radiotherapy s
hould be considered in cases with confirmed clinical local recurrence
without distant metastasis. Further prospective and randomized trials
have to be initiated to identify the patients with positive margins wh
o will benefit from adjuvant treatment.