The treatment of locally advanced prostate cancer remains controversial. Local failures after radical prostatectomy have led to the investigation of the potential beneficial effects of preoperative androgen deprivation. We review the literature that evaluates this therapeutic approach and present the results of our own experience. Downsizing was observed in most patients, with a concomittant drop in prostate-specific antigen levels, whereas downstaging was observed clinically in one-third of the patients but, in most cases, could not be confirmed on pathological examination. Most authors consider that clinical research in this direction should be addressed by carefully designed randomized trials.
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