High-risk prostate cancer represents a pretentious clinical problem since a significant number of its patients will relapse and progress after radical prostatectomy. Neoadjuvant chemotherapy may be valuable since its efficacy in hormone-resistant prostate cancer has been established. In this paper, we report studies of neoadjuvant chemotherapies that have been used in high-risk patients prior to radical prostatectomy. Even though the results regarding the prognostic surrogates are not significant, the effects on clinical and pathological outcomes are promising, while toxicity in most of the studies is in the expected field. 1. Introduction Prostate cancer (PCa) represents the most common malignancy in men and the second leading cause of death in Western countries [1]. According to the Surveillance, Epidemiology and End Results (SEER) program, for year 2012, 241740 new cases of PCa will be diagnosed in the United States of America, while 28170 men will die from the disease [1]. Implication of PCa screening in combination with recent advantages in diagnostic strategies has led to an increased detection of patients of early age with low-stage PCa. However, a treatment failure reaching 35%–40% will occur after primary therapy, and a kind of adjuvant treatment will be required [2, 3]. In an effort to identify those patients with high risk for recurrence and progression after treatment and with adverse pathological features after primary surgical management, in terms of extracapsular disease or seminal vesicles and lymph node invasion, stratification models have been introduced to categorize patients into risk groups [4, 5]. Risk stratification is based upon PSA, histological grade (Gleason score), and clinical stage. High-risk patients, meaning those with PSA levels >10？ng/mL, Gleason score >7, or clinical stage ≥T2c, have a significant higher possibility of biochemical relapse after treatment [4, 6]. Even in the era of PSA screening, 20%–35% of patients with newly diagnosed PCa are classified as high risk for adverse prognosis [4, 7]. The optimal treatment for these patients has not been standardized. Radical prostatectomy (RP) remains an option for these patients [8]. However, an increased incidence of treatment failure has been observed, and many of them will progress after RP mainly due to distant micrometastasis. For this reason, a multimodal therapeutic approach has been proposed for this certain group of patients in order to destroy remnant of cancerous cells at the operation bed or occult distant metastases. In the present work, we concentrate on the
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