total prostatectomy for localized prostatic cancer several treatment options currently are available for the patient with clinically localized carcinoma of the prostate and each has its proponents comparison of results between institutions becomes necessary to determine the relative value of these treatments keeping in mind the absence of a suitable control group in any series such interinstitutional treatment comparisons are possible only if the patient compositions are similar in terms of age grade and extent of disease comparisons of patients with stage b disease frequently are made because most urologists agree that these patients have palpable disease confined to the prostate and no evidence of metastasis at our clinic willing patients with clinically localized adenocarcinoma of the prostate who have an expected 15year survival are treated preferentially with total prostatectomy we summarize our experience with total prostatectomy in 215 consecutive patients including 213 who were available for followup there were 16 patients with clinical stage a 195 with clinical stage b and 2 with clinical stage c disease of these patients 207 underwent radical perineal prostatectomy and there were no operative deaths patients did not receive adjuvant hormonal therapy unless disease recurred of the 110 patients who have undergone the operation within the last 5 years 98 per cent are alive actual survival and survival free of disease respectively for the entire series were 55 and 48 per cent at 15 years 75 and 67 per cent at 10 years and 94 and 86 per cent at 5 years compared to 55 and 48 74 and 67 and 95 and 90 per cent respectively for the 195 patients with clinical stage b disease we believe these results demonstrate that in terms of local control of the disease overall survival and survival free of disease total prostatectomy remains the optimal treatment for patients with clinically localized carcinoma of the prostate