The majority of patients with prostate cancer who later develop lethal metastatic disease have high-risk localized disease at presentation, emphasizing the importance of effective treatment strategies at this stage. Multimodal treatment approaches that combine systemic and local therapies offer a promising strategy for improving the clinical outcomes of patients with high-risk localized prostate cancer. Combinations of neoadjuvant and adjuvant chemotherapy, hormonal therapy, or chemohormonal therapy are considered to be the standard of care in most solid tumours and should be investigated in the future for the treatment of prostate cancer to improve patient outcomes. However, although the combination of androgen deprivation therapy and radiotherapy is a standard of care in high-risk localized or locally advanced prostate cancer, the benefit of chemotherapy or chemohormonal therapy has yet to be demonstrated outside of the metastatic setting. Moreover, the benefit of neoadjuvant and/or adjuvant systemic therapies in combination with radical prostatectomy has not been proved. The development of next-generation hormonal agents, which have been approved for the treatment of castration-resistant prostate cancer, offers further therapeutic possibilities that are being assessed in early-phase clinical trials.

大多数后来发展为致命转移性疾病的前列腺癌患者在就诊时均具有局部高危疾病，强调了现阶段有效治疗策略的重要性。结合全身和局部疗法的多模式治疗方法为改善高危局限性前列腺癌患者的临床疗效提供了一种有前途的策略。新辅助化疗和辅助化疗，激素治疗或化学激素治疗的组合被认为是大多数实体瘤的治疗标准，将来应进行研究以治疗前列腺癌以改善患者预后。但是，尽管雄激素剥夺疗法和放射疗法相结合是高风险的局部或局部晚期前列腺癌的治疗标准，化学疗法或化学激素疗法的益处尚未在转移环境之外得到证实。此外，尚未证明新辅助和/或辅助全身疗法联合根治性前列腺切除术的益处。已批准用于治疗去势抵抗性前列腺癌的下一代激素药物的开发提供了进一步的治疗可能性，这些药物正在早期临床试验中进行评估。