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WOS: 000419740900007 Currently the accepted screening tools for prostate cancer are prostate specific antigen (PSA) and rectal examination. PSA is specific to prostate, but not to prostate cancer. Therefore, identifying prostate cancer only by serum PSA measurement has low specificity and may lead to false positive results and unnecessary biopsies. Due to these problems, it is investigated to increase the effectiveness of PSA and/or to find new biomarkers. However, it does not seem possible to have the adequate benefit from only one biomarker due to heterogeneous feature of prostate cancer. Therefore, in the recent years, combined use of biomarkers became a current issue and higher sensitivity and specificity rates were established.

WOS: 000219415700009 The exact definition of high-risk prostate cancer remains controversial. D'Amico defined it as a PSA value >20 ng/mL, biopsy Gleason score 8-10 or clinical stage >= T2c. High-risk prostate cancer is potentially lethal disease and accounts for 14-24% of all new diagnosis. The current role of radical prostatectomy and lymphadenectomy in patients with high-risk prostate cancer remains controversial. But, there are many substantial results that support the use of radical prostatectomy with extended pelvic lymph node dissection for patients with high-risk prostate cancer in current literature. So, radical prostatectomy and extended pelvic lymph node dissection must be represented as a primary treatment option for selected high-risk patients. This treatment can result in long-term progression-free survival.