The surgery of prostate cancer: An update of contemporary radical prostatectomy and brachytherapy series

Prostate cancer is the most commonly diagnosed malignancy among men in the United States. Radical prostatectomy has been the gold standard for treatin g clinically localized prostate cancer. Its morbidity and disease-control c apabilities have been well studied. At 10 years after surgery, 50% to 70% o f patients are disease-free. New advances in computerized dosimetry have re kindled interest in interstitial radiation therapy as an alternative form o f therapy. Because of inadequate duration of followup, the selection of pat ients with less virulent tumors, and the inconsistent definitions of bioche mical failure it is impossible to definitely compare the efficacy between t hese two different treatment options. Yet, even among highly selected patie nts with low-grade tumors, there may be a significant advantage in surgery as compared to interstitial monotherapy. The results of combined interstiti al and external radiotherapy have yielded lower failure rates, but long-ter m data is very limited. (C) 1999 Wiley-Liss, Inc.