1490 DOES THE PRESENCE OF BENIGN GLANDS AT THE APICAL SURGICAL MARGIN CORRELATE WITH A DETECTABLE POST-OPERATIVE ULTRASENSITIVE PSA LEVEL?

Abstract

You have accessJournal of UrologyProstate Cancer: Localized (VII)1 Apr 20131490 DOES THE PRESENCE OF BENIGN GLANDS AT THE APICAL SURGICAL MARGIN CORRELATE WITH A DETECTABLE POST-OPERATIVE ULTRASENSITIVE PSA LEVEL? Edan Shapiro, Vijay Goru, Crystal Castaneda, Trushar Patel, and Ketan Badani Edan ShapiroEdan Shapiro New York, NY More articles by this author , Vijay GoruVijay Goru New York, NY More articles by this author , Crystal CastanedaCrystal Castaneda New York, NY More articles by this author , Trushar PatelTrushar Patel New York, NY More articles by this author , and Ketan BadaniKetan Badani New York, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2969AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Detectable PSA levels following radical prostatectomy (RP) have traditionally been viewed as a surrogate for therapeutic failure, and a potential trigger for adjuvant therapy. However, certain postoperative PSA values can be attributable to the presence of benign prostatic glands. With increased use of ultrasensitive PSA (uPSA) postoperatively, it is unknown whether the presence of benign glands results in an early detectable uPSA. We sought to investigate whether the presence of benign prostatic glands on intraoperative apical biopsy results in detectable postoperative uPSA levels. METHODS Our IRB-approved Columbia Urologic Oncologic Database was retrospectively reviewed to identify patients who underwent intraoperative biopsy from the apical soft tissue (urethroprostatic junction). Patients with cancer on any pathologic surgical margin were excluded from the analysis. Apical biopsy findings were used to divide the cohort into those with benign glands or fibromuscular tissue. All patients underwent ultrasensitive PSA (uPSA) testing 3 months postoperatively, and a detectable uPSA was defined as >0.01 ng/mL. Cox regression analysis was performed to determine if presence of benign glands on intraoperative apical biopsy was associated with a detectable postoperative uPSA level, after controlling for age, preoperative PSA, pathologic Gleason, and pathologic stage. Analysis was repeated for different uPSA cutoff values (0.02, 0.03, and 0.04 ng/mL). RESULTS We identified 71 patients who underwent intraoperative apical biopsy and had uPSA follow-up data. Of these, 21 (30%) had benign glands on biopsy, and 50 (70%) had fibromuscular tissue. Overall, 8 (38%) of the patients with glands and 29 (56%) of the patients with fibromuscular tissue had a detectable uPSA (p=NS). On regression analysis, presence of benign glands was not associated with a detectable postoperative uPSA. CONCLUSIONS The presence of benign glands at the urethroprostatic margin does not appear to produce a clinically measurable postoperative uPSA in patients with localized prostate cancer. These findings suggest that any early detectable uPSA level following RP must be followed closely for potential disease recurrence. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e611 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Edan Shapiro New York, NY More articles by this author Vijay Goru New York, NY More articles by this author Crystal Castaneda New York, NY More articles by this author Trushar Patel New York, NY More articles by this author Ketan Badani New York, NY More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...