Surgery Plus Hormone Therapy for Advanced Prostate Cancer Shows Encouraging Results

Researchers evaluated 40 men with locally advanced or lymph node-positive prostate cancer who underwent robot-assisted radical prostatectomy with extensive lymph node removal, followed immediately by hormone therapy. All patients had PSA levels greater than 20 ng/mL before surgery and were followed for up to four years.

The operations were completed safely, with relatively little blood loss and a low complication rate. About 18% of patients had cancer cells at the edge of the removed tissue, suggesting that some cancer may have remained after surgery.

Recovery of urinary control was encouraging. Nearly two-thirds of the men regained urinary continence within one month after surgery, 85% by three months, 90% by six months, and 95% by one year.

Only two men experienced a return of their cancer, as measured by a rising PSA level, during the follow-up period.

Although this was a relatively small study with short-term follow-up, the results suggest that surgery combined with lymph node removal and immediate hormone therapy may be a safe and effective option for carefully selected men with locally advanced prostate cancer. Larger studies with longer follow-up will be needed to confirm these findings.

BMC Urology. Published November 18, 2025.