Organconfined disease

♦ Co-morbidity not significant

♦ Consider radical local therapy —prostatectomy

—radiotherapy

♦ Staging lymph node dissection, may be done laparoscopically

♦ Surgery may be better long-term for local control but effect on survival is uncertain

♦ High dose of conformal radiotherapy or brachytherapy may be as good

♦ Complications

—radical prostatectomy: 50% impotence; 8-15% long-term incontinence

—radical radiotherapy: 40% impotence; rectal stricture/bladder irritation but no incontinence

♦ Patients over 70 years —'wait and see' policy

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