An increasing number of cT3 PCa patients have been recently undergone RP. Recently, Touijer et al. reported open RP in selected patients with advanced stage PCa [16]. We previously reported LRP in T3 PCa patients with similar overall survival rates with T1 and T2 PCa patients [8, 9]. Additionally, RALP series on T3 PCa patients are increasing with high volume patients.

LRP and RALP are promising minimally invasive treatment options in T3 PCa patients [10]. These can provide similar oncological and functional results with open surgery [8, 9]. However, patients can recover faster than open surgery with well-known advantages of minimally invasive surgeries. On the other hand, there is a still financial problem in RALP in terms of robot and its arms are still expensive [8, 9]. Thus, LRP is one step ahead but it needs more practice and is difficult to perform for beginners in laparoscopy. Additional therapies may be needed after surgery [14]. Side effects of these should be discussed with patients and their partners. The HT may reduce sexual desire and can cause to erectile dysfunction. The RT may cause to some bowel and voiding problems. Nevertheless, patients should be informed for all these above.

Despite the limited data above, and we know that the importance of cancer specific survival in PCa. However, similar overall survival rates can be provided in cT3 PCa patients with cT1 and cT2, by LRP in terms of well-known advantages of laparoscopy [8, 9]. Finally, LRP is a plausible surgical option like upon surgery providing considerable oncological and functional results in advanced stage PCa.