Multimodality therapy for high-risk prostate cancer

Multimodal approach should be provided for high-risk prostate cancer patients. Androgen deprivation therapy (ADT) is a standard adjunct to radiotherapy for high-risk prostate cancer, but its role around prostatectomy has not been clearly defined. In a well-selected patient group, radical prostatectomy with adjuvant or salvage treatment when needed can yield very high long-term cancer control and survival rates. The role of pelvic lymph node dissection during radical prostatectomy is still controversial. Recent randomized controlled trials have demonstrated improved outcomes with the combination of radiotherapy in conjunction with ADT and docetaxel for high-risk prostate cancer. Innovations to detect oligometastasis, and systemic chemotherapies combined with local therapy will open up new landscape for further improved outcomes in patients with high-risk prostate cancer.