Fundamentals on the pathology of prostatic carcinoma after brachytherapy

Morphologic analyses of radical prostatectomy specimens after brachytherapy are rarities, as only few patients undergo radical prostatectomy due to prostate-specific antigen (PSA) progress after brachytherapy. In the literature, there are merely sporadic reports that do essentially correspond to findings after conventional radiotherapy with regressive changes in the tumor glands and, especially, in the surrounding stroma. From the presented cases, it can be concluded that the seed density must be very high in order to prevent tumor progression through undamaged parts of the carcinoma. The sequels of brachytherapy are compared with the reactions of prostatic carcinomas to various modes of therapy. It is demonstrated what the clinician can expect and which modes of control exist at present.