129 NATURAL HISTORY OF PROSTATE CANCER PATIENTS WITH MICROMETASTASES IN PELVIC LYMPH NODES DETECTED BY REAL-TIME REVERSE TRANSCRYPTASE POLYMERASE CHAIN REACTION

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology and Natural History I1 Apr 2010129 NATURAL HISTORY OF PROSTATE CANCER PATIENTS WITH MICROMETASTASES IN PELVIC LYMPH NODES DETECTED BY REAL-TIME REVERSE TRANSCRYPTASE POLYMERASE CHAIN REACTION Toshifumi Kurahashi, Hideaki Miyake, Atsushi Takenaka, and Masato Fujisawa Toshifumi KurahashiToshifumi Kurahashi More articles by this author , Hideaki MiyakeHideaki Miyake More articles by this author , Atsushi TakenakaAtsushi Takenaka More articles by this author , and Masato FujisawaMasato Fujisawa More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.180AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We previously reported the usefulness of real-time RT-PCR targeting several genes specifically expressed in the prostate gland for detecting mictometastatic tumor foci in pelvic lymph nodes (LNs) from patients with localized prostate cancer (Clin Cancer Res 2007; 13: 1192-7, BJU Int 2007; 99: 315-20). The objective of this study was to characterize the natural history of patients who underwent radical prostatectomy (RP) without any neoadjuvant therapies and were subsequently diagnosed as having micrometastases by real-time reverse-transcriptase PCR (RT-PCR). METHODS Expression of prostate-specific antigen (PSA), prostate-specific membrane antigen (PSMA), human kallikrein 2 (hK2), prostate stem cell antigen (PSCM) and DD3 genes in 2215 LNs isolated from the 120 patients with clinically localized prostate cancer were assessed by a fully quantitative real-time RT-PCR. In this series, biochemical recurrence (BR) was defined as a serum PSA 0.2 ng/mL or greater on two consecutive measurements, and none of the patients received any adjuvant therapies until their serum PSA levels reached 0.4 ng/mL or greater. RESULTS In addition to pathologically diagnosed 29 LNs from 11 patients, real-time RT-PCR targeting PSA, PSMA, hK2, PSCM and DD3 further identified micrometastasis in 84, 112, 99, 67 and 53 LNs from 23, 29, 29, 15 and 11 patients with no pathological evidence of LN involvement, respectively. During the observation period of this study (median, 73 months), BR occurred in 32 patients (26.7%), of whom 25, 22, 28, 10 and 9 were diagnosed as having micrometastasis by real-time RT-PCR targeting PSA, PSMA, hK2, PSCM and DD3, respectively. BR-free survival between patients with pathologically confirmed LN metastasis was significantly poor than those with micrometastases detected by real-time RT-PCR targeting a single gene. Of several combinations of target genes, however, there was no significant difference in BR-free survival between patients positive for micrometastasis detected by PSA and/or hK2 and those with pathological LN metastasis. Furthermore, the presence of micrometastases diagnosed by the combined outcomes from real-time RT-PCR targeting PSA and/or hK2 was identified as an independent predictor of BR-free survival on multivariate analysis. CONCLUSIONS The natural history in patients who are diagnosed as having micrometastasis in pelvic LNs by real-time RT-PCR targeting PSA and/or hK2 genes is likely to be similar to that in those positive for pathological LN metastasis. Kobe, Japan© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e52-e53 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Toshifumi Kurahashi More articles by this author Hideaki Miyake More articles by this author Atsushi Takenaka More articles by this author Masato Fujisawa More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...