Radical Prostatectomy in Treating Patients With Locally Advanced Prostate Cancer

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Histologically confirmed adenocarcinoma of the prostate
• •* Unilateral cT3a, cN0, M0
• •Well or moderately differentiated tumor
• •* Gleason score no greater than 7 (4 plus 3 or 3 plus 4)
• •Total serum prostate-specific antigen no greater than 20 ng/mL (Hybritech equivalent)
• •PATIENT CHARACTERISTICS:
• •Age:
• •70 and under
• •Performance status:
• •WHO 0-1
• •Life expectancy:
• •Not specified
• •Hematopoietic:
• •WBC greater than 3,000/mm\^3
• •Platelet count greater than 100,000/mm\^3
• •Hemoglobin greater than 9 g/dL
• •Hepatic:
• •Bilirubin no greater than 1.5 times normal
• •ALT or AST less than 3 times normal
• •PT and PTT normal
• •Renal:
• •Creatinine no greater than 1.5 mg/dL
• •Cardiovascular:
• •No preexisting uncontrolled cardiac disease, signs of cardiac failure, or rhythm disturbances requiring therapy
• •No myocardial infarction within the past 6 months
• •Pulmonary:
• •No gross abnormalities on chest x-ray
• •Other:
• •No other disease that would preclude surgery
• •No other prior malignancy except adequately treated basal cell skin cancer
• •No other concurrent primary malignancy
• •No psychological, familial, sociological, or geographical condition that would preclude compliance
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy:
• •Not specified
• •Chemotherapy:
• •Not specified
• •Endocrine therapy:
• •No prior hormonal therapy that would affect assessment of clinical T staging, margin positivity, or definitive pT staging
• •Radiotherapy:
• •No prior pelvic radiotherapy that would affect surgical resectability and perioperative morbidity
• •Surgery:
• •No prior surgery in the small pelvis (vascular surgery, mesh graft hernia repair, any surgery for benign prostatic hypertrophy, or transurethral resection of prostate) that would preclude prostatectomy