Adjuvant medical treatment or radiotherapy following radical prostatectomy or curative radiotherapy

Treatment of prostate cancer with a high risk of recurrence following local treatment (surgery or radiotherapy) remains a controversial subject. Adjuvant treatment must be scheduled if there are factors for a poor prognosis from the anatomopathologic results of biopsies or the excised prostate. The aim of this treatment is to destroy any remaining tumour cells after curative treatment. In a review of the literature, one can note the various adjuvant treatments according to their indications, A benefit has been demonstrated for adjuvant radiotherapy following radical prostatectomy with capsular invasion or positive margins, This is of interest in terms of survival with biological recurrence. However, no study has demonstrated a benefit in terms of overall survival. Following curative radiotherapy, there is also a specific benefit of adjuvant hormonal therapy. This benefit consists of a significant improvement in survival without progression, specific survival and overall survival. All in all, it would appear that patients with a high risk of progression who were initially treated by radiotherapy or radical prostatectomy can benefit from the adjuvant therapeutic alternatives that have demonstrated their interest. The decision to perform adjuvant treatment following curative treatment should he discussed at weekly interdisciplinary meetings.