One of the main issues with prostatectomies is the potential for positive surgical margins. When the cancer is found to have extended to the edge of the removed prostate, it is presumed that some cancer tissue was left in the body. Studies have shown that when this happens, the recurrence rate goes up nearly 400%. If your cancer is in the apex of the prostate, you chances of having positive surgical margins is quite high.
Currently there is some intensive research to find ways to avoid positive margins, and several centers are reporting great success using new surgical techniques. An interesting article from the University of California, Irvine, discusses the issue and some of the new techniques: http://www.urology.uci.edu/prostate/Margins.html.
As you can see, before you sign on the dotted line for your surgery, you should first ask about the risk for positive margins, and if they exist, whether your surgeon is up on the latest techniques. Or perhaps even go straight to one of the centers that specialize in the techniques for your surgery.
Sure wish I had.