Adjuvant therapy in prostate cancer: Patient identification and treatment options

The recent downward shift in disease stage and patient age at diagnosis has led to an emphasis on definitive local therapy in patients with prostate cancer. However, patients with adverse prognostic factors (non-organ-confined disease, high prostate-specific antigen level, high Gleason score) have a significant risk of treatment failure. With our increasing ability to predict patients at high risk of failure, more patients are likely to receive adjuvant therapy. Adjuvant hormonal therapy extends overall survival after radiotherapy for locally advanced disease, while after surgery improved survival has been demonstrated in patients with node-positive disease. More recently, adjuvant chemotherapy has been investigated.