Les grands principes des traitements du cancer de prostate localisé

Abstract

Prostate cancer (PCa) was in 2020 the second most common cancer in men after lung cancer, and the 5th leading cause of cancer death worldwide. Eighty percent of patients with PCa are diagnosed at a localized stage. The therapeutic approach depends on the risk classification. Active surveillance is one of the standard treatments for low-risk PCa, and can be proposed for selected patients with intermediate-risk PCa. Radical approaches are mainly represented by surgery or radiotherapy (alone or combined with androgen deprivation therapy). Focal therapies provide the advantage of a better sparing of adjacent healthy tissue, with encouraging early results from an oncological point of view, but their interpretation remains limited by a relatively short follow-up period. On a systemic level, androgen deprivation therapyis the key treatment in combination with radiotherapy for unfavorable intermediate or high-risk PCa. Second-generation hormone therapies have a new and growing place in the management of very high-risk (or locally advanced) localized prostate cancer. The aim of this review is to detail the various local and systemic treatments that can be offered to patients diagnosed with localized CaP.