Abstract
Objectives: To investigate monocyte chemotactic protein-1 (MCP-1) as a novel urinary biomarker to predict prolonged post prostatectomy incontinence. Methods: Men submitted urine samples prior to robotic radical prostatectomy. MCP-1 values were derived using an ELISA test. Pad usage at 7, 30, and 60 days were documented by patient post cards mailed when zero pads was reached. The primary outcome was defined as no incontinence pad usage at 30 days at prostatectomy. Results: After exclusions, 76 patients were included in analyses. Continence was reached by 29% (22/76), 56% (42/76), and (75/76) 98% at 7, 30, and 60 days, respectively. The average MCP-1 (p=0.258) was not different between the continent and incontinent groups. Highest quartile of MCP-1 (MCP > 166 pg/mL) and normalized MCP-1 (MCP-1/TV >0.53) noted a significant delay in continence at 30 days (p=0.050 and p=0.003). Only 26% (5/19) in the highest MCP1/TV quartile were continent, whereas 65% (37/57) of men in the 3 lower quartiles reached zero pad continence (p=0.003). In a logistic regression model the highest quartile of MCP1/TV had a significant chance of being incontinent at 30 days (OR 0.22; 95% CI 0.058-0.80; p=0.022). Conclusion: MCP-1/TV is a urinary biomarker that may predict prolonged urinary incontinence after radical prostatectomy.
Highlights
Prostate cancer, the most common non-cutaneous malignancy prevalent in males, is the 2nd leading cause of death compared to other cancers in men [1]
De novo detrusor instability after prostatectomy can lead to overactive bladder (OAB) symptoms, which may be detectable by urodynamic evaluation [9]
A previous study using a proteomics chip based analysis of urinary cytokine expression demonstrated that OAB group expressed Monocyte Chemotactic Protein-1 (MCP-1) two-fold higher than UTI population and controls, suggesting MCP-1 to be a potential target for an OAB biomarker [10]
Summary
The most common non-cutaneous malignancy prevalent in males, is the 2nd leading cause of death compared to other cancers in men [1]. Lack of the knowledge on the preoperative biomarkers alluding to postoperative incontinence is a limiting factor in the counseling process because the information may potentially be used as an additional component at the time of counseling To this end, a previous study using a proteomics chip based analysis of urinary cytokine expression demonstrated that OAB group expressed Monocyte Chemotactic Protein-1 (MCP-1) two-fold higher than UTI population and controls, suggesting MCP-1 to be a potential target for an OAB biomarker [10]. A previous study using a proteomics chip based analysis of urinary cytokine expression demonstrated that OAB group expressed Monocyte Chemotactic Protein-1 (MCP-1) two-fold higher than UTI population and controls, suggesting MCP-1 to be a potential target for an OAB biomarker [10] Based on these premises, we conducted a clinical study to assess whether urinary MCP-1 can be a potential preoperative biomarker associated with the outcome of 30-day urinary continence after robotic radical prostatectomy (RRP)
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