| Popis: |
Radical prostatectomy can cure cancer of the prostate if the malignancy is localized within the gland and the patient has a life expectancy sufficiently long enough to appreciate efficacy. The expectations raised by this technical progress, particularly since the number of diagnosed cases is constantly on the rise, should however be tempered by questions concerning indications and therapeutic efficacy, pathology findings in surgical specimens, factors of prognosis and certain doubts about the quality of life, therapeutic alternatives and cost evaluation. 10-year survival after radical prostatectomy is 85% for localized (pT1 and pT2) forms and prostate specific antigen levels provide an easily accessible means of detecting recurrence. However, due to the insufficient sensitivity of imaging techniques, preoperative staging is generally underestimated compared with pathology reports. Postoperative incontinence is the major factor in quality of life after prostatectomy and has been estimated to concern from 0% to 26% of the patients. No comparative data is available to evaluate alternative treatment such as external radiotherapy. These observations emphasize the uncertain nature of current indications for radical prostatectomy and the importance of further research. |
