@Article{,
AUTHOR = {Bilal Chughtai, Badar M. Mian},
TITLE = {High risk prostate cancer: evolving defi nition and approach to management},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {15},
YEAR = {2008},
NUMBER = {6},
PAGES = {4375--4380},
URL = {http://www.techscience.com/CJU/v15n6/62237},
ISSN = {1488-5581},
ABSTRACT = {Advances in the early detection and treatment of prostate 
cancer have progressed far beyond our ability to identify 
patients with high risk prostate cancer. In general, 
designation of high risk prostate cancer implies the presence 
of disease that is likely become progressive or lethal if not 
managed aggressively. Without proper risk stratifi cation, 
there is a signifi cant likelihood of both overtreatments of 
men with low risk disease and undertreatment for men with 
high risk cancer. The major issues surrounding the clinical 
management of high risk prostate cancer revolve around 
the defi nition of high risk disease as well as the benefi ts 
of multiple modality therapy. Over the years, numerous 
attempts have been made to develop risk assessment tools 
such as risk categories, scoring systems and nomograms, 
but a widely accepted defi nition is yet to be determined. The 
benefi ts of routine clinical utility of these risk assessment 
tools remain somewhat diffi cult to ascertain. We will discuss 
several multimodality therapeutic approaches, especially in 
combination with androgen ablation, to improve the outlook 
for men with high risk or locally advanced prostate cancer. 
This review focuses on the potential limitations of the risk 
assessment tools available to the clinicians and the approach 
to management of high risk prostate cancer.},
DOI = {}
}