Objective: Aim of the study was to assess the outcome of radical prostatectomy in locally advanced prostate cancer patients in terms of functional outcome, benefit of adjuvant therapy, biochemical recurrence and survival.Patients and methods: We looked retrospectively into our database between March 1992 and December 2009, 327 patients performed radical retropubic prostatectomy for prostate cancer. All operations were performed by a single surgeon. Locally advanced prostate cancer was pathologically diagnosed in 93 patients.Results: Our results show that radical prostatectomy proved to be technically feasible in a consecutive series of unselected non-bone metastatic advanced prostate cancers. The intraoperative, postoperative complication profile and functional outcome in the form of continence results did not differ significantly from that observed in clinically organ-confined disease. The 10 year actuarial overall survival was 94% for the locally advanced prostate cancer patients and the 5 and 10 year actuarial biochemical free survival was 62% and 16% respectively. When T3 and T4 stages were compared; T3 showed a 5 and 10 year biochemical free survival of 65% and 22% respectively, while T4 showed a 5 year biochemical free survival of 33% with trending statistical significance for the T3 group. No statistical difference was found when comparing the effect of preoperative PSA, surgical margin status, seminal vesicle invasion and lymph nodes status.Conclusion: Survival and functional data suggest the potential role of surgery as an essential part of the multimodal approach to treating advanced prostate cancer.