DOI: https://doi.org/10.36347/sjmcr.2026.v14i05.068

Pages: 1153-1156

Objective: To evaluate early oncologic outcomes and functional tolerance of a multimodal strategy combining radical prostatectomy, postoperative radiotherapy, and hormone therapy in patients with localized or locally advanced prostate cancer at intermediate to high risk. Materials and methods: This was a retrospective, descriptive, single-center study conducted at the Mohammed VI Center for Cancer Treatment, Ibn Rochd University Hospital, Casablanca, between January 2020 and December 2025. Thirty patients with non-metastatic prostatic adenocarcinoma were included. All underwent radical prostatectomy followed by either adjuvant or salvage radiotherapy, together with adjuvant hormone therapy. Clinical, biological, pathological, therapeutic, toxicological, and outcome data were analyzed. Results: The mean age was 66 years, and the mean initial PSA level was 16.55 ng/mL. According to the D’Amico classification, 60% of patients were high risk. On pathological examination, 74% of tumors were staged pT3, 53% had positive surgical margins, and 20% had nodal involvement (pN+). Radiotherapy was delivered in the adjuvant setting in 67% of cases and as salvage treatment in 33%, with a mean dose of 66 Gy. The mean duration of hormone therapy was 16.8 months. Postoperative sequelae included urinary incontinence in 83% of patients and erectile dysfunction in 100%. Acute genitourinary and gastrointestinal radiotherapy toxicity was observed in 70% and 50% of cases, respectively; late genitourinary and gastrointestinal toxicity occurred in 33% and 30% of patients, respectively. After a median follow-up of 12.5 months following combined radiotherapy and hormone therapy, overall survival was 100%, and locoregional recurrence was documented in 7% of patients. Conclusion: In this series, multimodal treatment achieved excellent early oncologic control in patients with unfavorable pathological features. However, urinary and sexual toxicity was substantial, underscoring the need for careful