**8. Conclusions**

Many cancers, categorized clinically as high risk, are actually pathologically confined to the prostate, and most men with such cancers who undergo RP, are free of additional therapy long after surgery.

For men with high-risk, clinically localized prostate cancer, decisions on whether to elect surgery as local definitive therapy should be based on the best available clinical evidence rather than on an individual practitioner's experiences and biases.

Radical Prostatectomy in High Risk Prostate Cancer 147

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Patients classified with high-risk prostate cancer, by commonly used definitions, are at increased risk of PSA failure, need for secondary therapy, metastatic progression, and death from systemic disease. Nevertheless, such high risk patients do not have a uniformly poor prognosis after RP.

