Prostate cancer (PC) is now one of the most common malignancies among men. Radical prostatectomy is the most commonly used therapy option for patients with localized PC. The appropriateness of surgical treatment for locally advanced and lymphogenic metastatic PC remains controversial, as the probability of non-radical intervention increases significantly and the risk for disease progression becomes higher. At the same time, interest in surgical treatment in patients with PC at high risk of progression, including those with lymphogenic metastases has recently increased greatly. There are more and more studies demonstrating improved survival rates in patients with high-risk PC, including those with distant metastases, who have undergone radical prostatectomy and lymphadenectomy compared with a cohort of patients who have received only drug therapy In addition to the studies evaluating the efficiency of neoadjuvant therapy before surgery in patients with localized or locally advanced high-risk PC, there are also investigations considering this option in PC patients with lymphogenic metastases. The paper gives the results of a clinical observation that shows the high efficiency of a multimodal approach with neoadjuvant chemohormonal therapy, followed by surgical treatment in a patient with lymphogenic metastatic PC.