Tijdschrift voor gerontologie en geriatrie
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Tijdschr Gerontol Geriatr · Apr 1998
Review Comparative Study[The treatment of locally advanced (T3) prostatic carcinoma using radical prostatectomy or radiotherapy. A review].
In the Netherlands 16% of all newly diagnosed prostatic carcinomas are already locally advanced (TNM-system: T3), which means that the tumor spreads beyond the prostatic capsule, or grows into the seminal vesicles. The pre-operative clinical staging is not very reliable when local tumor 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 tumors spread outside the prostate is found; and in 18% of the T3 tumors the tumor is confined to the prostate. ⋯ There is, however, a subgroup of patients with undifferentiated carcinoma which shows high progression rates following radical prostatectomy; these patients 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.