The role of surgery for high-risk prostate cancer

Because of PSA screening, urologists can detect clinically localized prostate cancer in patients before the disease has progressed to advanced stages. Nevertheless, some patients are still diagnosed with high-risk prostate cancer. Surgery for high-risk prostate cancer is applied frequently nowadays. Nevertheless, this approach is still surrounded by many controversies. In some high-risk prostate cancer patients, surgery is a one-step modality in treatment and has an excellent oncological prognosis. However, because of the lack of evidence and well-controlled comparative prospective studies, the best course of treatment can be unclear, and oncological outcomes often appear heterogeneous. The aim of this review is to discuss the role of surgery in high risk prostate cancer.