Robotic surgical management for extremely high-risk prostate cancer: case report and overview of recent literature evidences in the setting

Abstract

Radical prostatectomy is recommended as a part of the multimodal treatment of high-risk or clinically advanced non-metastatic prostate cancer (PCa). In those cases, surgery could be challenging due to the possible cancerous invasion of peri-prostatic tissues that adversely affect the exposition and dissection. Moreover, a prior hormonal therapy may alter the plane between the rectum and prostate, likely resulting in an increased rate of local complications (ie rectal perforation) [1, 2]. According to the EAU Guidelines, the definition of high-risk cancer includes a PSA value exceeding 20 ng/ml. We describe the case of a young man presenting with a PSA value of 188 ng/ml, managed through robotic radical prostatectomy (RALP) at a referral center as a part of multimodal approach.