Medical Dialogues
  • Dermatology
Login Register
This site is intended for healthcare professionals only
Login Register
  • MD Brand Connect
  • Vaccine Hub
  • MDTV
    • Breaking News
    • Medical News Today
    • Health News Today
    • Latest
    • Journal Club
    • Medico Legal Update
    • Latest Webinars
    • MD Shorts
    • Health Dialogues
  • Fact Check
  • Health Dialogues
Medical Dialogues
  • Medical News & Guidelines
      • Anesthesiology
      • Cardiology and CTVS
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endocrinology
      • ENT
      • Gastroenterology
      • Medicine
      • Nephrology
      • Neurology
      • Obstretics-Gynaecology
      • Oncology
      • Ophthalmology
      • Orthopaedics
      • Pediatrics-Neonatology
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
      • Laboratory Medicine
      • Diet
      • Nursing
      • Paramedical
      • Physiotherapy
  • Health news
      • Doctor News
      • Government Policies
      • Hospital & Diagnostics
      • International Health News
      • Medical Organization News
      • Medico Legal News
      • NBE News
      • NMC News
  • Fact Check
      • Bone Health Fact Check
      • Brain Health Fact Check
      • Cancer Related Fact Check
      • Child Care Fact Check
      • Dental and oral health fact check
      • Diabetes and metabolic health fact check
      • Diet and Nutrition Fact Check
      • Eye and ENT Care Fact Check
      • Fitness fact check
      • Gut health fact check
      • Heart health fact check
      • Kidney health fact check
      • Medical education fact check
      • Men's health fact check
      • Respiratory fact check
      • Skin and hair care fact check
      • Vaccine and Immunization fact check
      • Women's health fact check
  • AYUSH
    • Ayurveda
    • Homeopathy
    • Siddha
    • Unani
    • Yoga
  • State News
      • Andaman and Nicobar Islands
      • Andhra Pradesh
      • Arunachal Pradesh
      • Assam
      • Bihar
      • Chandigarh
      • Chattisgarh
      • Dadra and Nagar Haveli
      • Daman and Diu
      • Delhi
      • Goa
      • Gujarat
      • Haryana
      • Himachal Pradesh
      • Jammu & Kashmir
      • Jharkhand
      • Karnataka
      • Kerala
      • Ladakh
      • Lakshadweep
      • Madhya Pradesh
      • Maharashtra
      • Manipur
      • Meghalaya
      • Mizoram
      • Nagaland
      • Odisha
      • Puducherry
      • Punjab
      • Rajasthan
      • Sikkim
      • Tamil Nadu
      • Telangana
      • Tripura
      • Uttar Pradesh
      • Uttrakhand
      • West Bengal
  • Medical Education
      • Ayush Education News
      • Dentistry Education News
      • Medical Admission News
      • Medical Colleges News
      • Medical Courses News
      • Medical Universities News
      • Nursing education News
      • Paramedical Education News
      • Study Abroad
  • Industry
      • Health Investment News
      • Health Startup News
      • Medical Devices News
      • Pharma News
      • Pharmacy Education News
      • Industry Perspective
  • MDTV
      • Health Dialogues MDTV
      • Health News today MDTV
      • Latest Videos MDTV
      • Latest Webinars MDTV
      • MD shorts MDTV
      • Medical News Today MDTV
      • Medico Legal Update MDTV
      • Top Videos MDTV
      • Health Perspectives MDTV
      • Journal Club MDTV
      • Medical Dialogues Show
This site is intended for healthcare professionals only
LoginRegister
Medical Dialogues
LoginRegister
  • Home
  • Medical news & Guidelines
    • Anesthesiology
    • Cardiology and CTVS
    • Critical Care
    • Dentistry
    • Dermatology
    • Diabetes and Endocrinology
    • ENT
    • Gastroenterology
    • Medicine
    • Nephrology
    • Neurology
    • Obstretics-Gynaecology
    • Oncology
    • Ophthalmology
    • Orthopaedics
    • Pediatrics-Neonatology
    • Psychiatry
    • Pulmonology
    • Radiology
    • Surgery
    • Urology
    • Laboratory Medicine
    • Diet
    • Nursing
    • Paramedical
    • Physiotherapy
  • Health news
    • Doctor News
    • Government Policies
    • Hospital & Diagnostics
    • International Health News
    • Medical Organization News
    • Medico Legal News
    • NBE News
    • NMC News
  • Fact Check
    • Bone Health Fact Check
    • Brain Health Fact Check
    • Cancer Related Fact Check
    • Child Care Fact Check
    • Dental and oral health fact check
    • Diabetes and metabolic health fact check
    • Diet and Nutrition Fact Check
    • Eye and ENT Care Fact Check
    • Fitness fact check
    • Gut health fact check
    • Heart health fact check
    • Kidney health fact check
    • Medical education fact check
    • Men's health fact check
    • Respiratory fact check
    • Skin and hair care fact check
    • Vaccine and Immunization fact check
    • Women's health fact check
  • AYUSH
    • Ayurveda
      • Ayurveda Giuidelines
      • Ayurveda News
    • Homeopathy
      • Homeopathy Guidelines
      • Homeopathy News
    • Siddha
      • Siddha Guidelines
      • Siddha News
    • Unani
      • Unani Guidelines
      • Unani News
    • Yoga
      • Yoga Guidelines
      • Yoga News
  • State News
    • Andaman and Nicobar Islands
    • Andhra Pradesh
    • Arunachal Pradesh
    • Assam
    • Bihar
    • Chandigarh
    • Chattisgarh
    • Dadra and Nagar Haveli
    • Daman and Diu
    • Delhi
    • Goa
    • Gujarat
    • Haryana
    • Himachal Pradesh
    • Jammu & Kashmir
    • Jharkhand
    • Karnataka
    • Kerala
    • Ladakh
    • Lakshadweep
    • Madhya Pradesh
    • Maharashtra
    • Manipur
    • Meghalaya
    • Mizoram
    • Nagaland
    • Odisha
    • Puducherry
    • Punjab
    • Rajasthan
    • Sikkim
    • Tamil Nadu
    • Telangana
    • Tripura
    • Uttar Pradesh
    • Uttrakhand
    • West Bengal
  • Medical Education
    • Ayush Education News
    • Dentistry Education News
    • Medical Admission News
    • Medical Colleges News
    • Medical Courses News
    • Medical Universities News
    • Nursing education News
    • Paramedical Education News
    • Study Abroad
  • Industry
    • Health Investment News
    • Health Startup News
    • Medical Devices News
    • Pharma News
      • CDSCO (Central Drugs Standard Control Organisation) News
    • Pharmacy Education News
    • Industry Perspective
  • Home
  • Urology
  • Urology News
  • Residual benign...

Residual benign prostate glandular tissue not tied to detectable PSA after radical prostatectomy: Study

Written By : Dr Nisanth Puliyath |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-08-24T09:00:32+05:30  |  Updated On 24 Aug 2021 2:16 PM IST
Residual benign prostate glandular tissue not tied to detectable PSA after radical prostatectomy: Study
  • facebook
  • twitter
  • linkedin
  • whatsapp
  • Telegram
  • Email

Radical prostatectomy (RP) is the established treatment modality for clinically localized prostate cancer. Ideally, serum prostate specific antigen (PSA) values should become undetectable after RP; however, studies have found detectable PSA in up to 16.4% of men after definitive treatment, without oncologic recurrence. After RP, 28%–73% will have benign glandular tissue at the surgical margin (BGM) diagnosed on surgical pathology. There is a concern that benign, rather than malignant, residual tissue could account for detectable serum PSA after RP, especially low serum PSA values.

In many previous studies, benign glandular tissue at the surgical margin (BGM) has been evaluated as a potential risk factor for biochemical recurrence (BCR) and poor disease prognosis in open radical prostatectomies (ORPs), but no difference in patient outcomes were seen based on benign glandular tissue at the surgical margin (BGM)-status. However, with the current widespread use of robotic assisted laparoscopic radical prostatectomy (RALP) there is a paucity of data evaluating the association of BGM and postoperative detectable PSA or risk of BCR despite comparative studies indicating an increased risk of BGM with RALP compared to ORP.

Study design

The study was reported by researchers at The University of California, San Francisco's (UCSF) on clinical urologic outcomes database to identify patients treated with either ORP or RALP between 2004–2018. They studied "if benign glandular tissue at the surgical margin (BGM) is associated with detectable prostate specific antigen (PSA) and/or biochemical recurrence (BCR) after radical prostatectomy (RP)."

In this study surgical specimens were received by pathologists intact and inked for margin analysis. The gross specimen was subsequently serially cross-sectioned at 3–6 mm intervals perpendicular to the urethral axis. BGM was defined as benign prostatic glands at the inked margin and reported as a binary variable (present/absent). Malignancy at the surgical margin (MSM) was defined as tumor at the inked margin.

The researchers used regression analysis to identify demographic, clinical and surgical factors associated with the likelihood of BGM presence on surgical pathology. Oncologic outcomes included detectable PSA (>0.03 ng/ml), BCR (≥0.2 ng/ml) and progression to BCR or salvage treatment after detectable PSA

Results:

• "In 1,082 men followed for a median time of 49 months, the presence of BGM after RP is not associated with an increased risk of MSM, detectable PSA, BCR, or progression from detectable PSA to BCR or salvage treatment."

• BGM was present on 249 (23%) specimens. Younger age, bilateral nerve sparing surgery and robotic approach were associated with presence of BGM while malignancy at the surgical margin (MSM) was not.

• In the subgroup of men who reached detectable PSA, 79% had progression within 7 years.

• At 7 years after RP, 29% experienced detectable PSA and 11% had BCR.

• To date, this is the largest study evaluating BGM outcomes after RALP and the first to evaluate the association between BGM and risk of detectable PSA.

• Although RALP for the surgical treatment of prostate cancer has been widely adopted, contemporary data regarding the association of BGM and BCR has been lacking despite multiple studies demonstrating an increased risk of BGM with RALP.

• As there was no difference in detectable PSA or BCR between BGM-present and BGM-absent cohorts, the theoretically more aggressive approach to preserve functional outcomes appears to be of no consequence in this study.

Conclusion

The researchers concluded that "The presence of benign glandular prostatic tissue at RP was not associated increased risk of Malignancy at the surgical margin (MSM), detectable PSA, BCR, progression from detectable PSA to BCR or salvage therapy."

Source: Greenberg SA et al.; J Urol. 2021 Sep 1;206(3):706–14. https://doi.org/10.1097/JU.0000000000001793



UrologyProstatectomyPSA testRadical prostatectomy
Article Source :  Journal of Urology
Dr Nisanth Puliyath
Dr Nisanth Puliyath

    MBBS, MS

    Dr Nisanth Puliyath (MBBS, MS) has completed his MBBS from Calicut Medical College and MS General Surgery from AIIMS Rishikesh. He has published several peer-reviewed papers in both national and international journals. He has presented posters and papers at various national conferences and won prizes for the same. He is a surgeon with a keen interest in the latest literature and technical advances in the fields of Surgery and Urology. He can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

    Show Full Article
    Next Story

    Editorial

    Azmarda Outperforms Generic Sacubitril/Valsartan in HFrEF Management, says new study

    Azmarda Outperforms Generic Sacubitril/Valsartan in HFrEF Management, says new study

    First Indian Consensus on Managing Refractory Gastroesophageal Reflux Disease Recommends Vonoprazan

    First Indian Consensus on Managing Refractory Gastroesophageal Reflux Disease Recommends Vonoprazan

    Re-visiting the Role of Pneumococcal Vaccination in Patients with Cardiovascular Diseases

    Re-visiting the Role of Pneumococcal Vaccination in Patients with Cardiovascular Diseases

    Prediabetes and the Mind: Unraveling Cognitive and Mental Health Risks

    Prediabetes and the Mind: Unraveling Cognitive and Mental Health Risks

    Real-World Case study: Darbepoetin Alfa for Chemotherapy-Induced Anemia in Metastatic Breast Cancer - Dr Aditya Murali

    Real-World Case study: Darbepoetin Alfa for Chemotherapy-Induced Anemia in Metastatic Breast Cancer...

    View All

    Journal Club Today

    Universal Heart Health Advice Ignores Realities in Low-Income Countries: Study Finds

    Universal Heart Health Advice Ignores Realities in Low-Income Countries: Study Finds

    View All

    Health News Today

    Health Bulletin 24/May/2025

    Health Bulletin 24/May/2025

    View All
    © 2022 All Rights Reserved.
    Powered By: Hocalwire
    X
    We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok