Editing Management of Localized Prostate Cancer (section)

== Comparing RP and radiotherapy ==

* '''No RCT comparing RP to radiotherapy'''
* No modality affords 100% local control.
** Surgery is more likely to fail at the margins, and radiotherapy is more likely to fail in the center of the tumor.
** An important limitation of radiotherapy is tumor heterogeneity with respect to radiation sensitivity. Tumor persistence within the fields of radiation may occur in up to 40% of patients with clinically localized prostate cancer treated with radiation therapy. The strategies of using ADT, dose escalation, and better dose placement are designed to improve the central local control.