Abstract
ObjectivesTo investigate whether the preoperative detection of prostate stem cell antigen (PSCA) mRNA in blood has predictive value for biochemical recurrence, overall survival, and cancer-specific survival after radical prostatectomy in patients with high-risk prostate cancer.ResultsMedian age was 67 years (interquartile range: 63-71), and median follow-up was 41 months (interquartile range: 25–65). PSCA mRNA was detected in 151 patients (51.1%). Biochemical recurrence was developed in 101 patients (34.2%), and all-cause mortality and prostate cancer-specific mortality occurred in 17 (5.7%) and 8 (2.7%) patients, respectively. Kaplan–Meier analysis revealed significant differences in biochemical recurrence, overall survival, and cancer-specific survival according to PSCA mRNA positivity. Cox regression hazards model analysis showed that PSCA mRNA positivity was an independent predictor of biochemical recurrence, overall survival, and cancer-specific survival.ConclusionsPSCA mRNA in the peripheral blood was related to poor prognosis. Detection of PSCA mRNA by polymerase chain reaction in peripheral blood can be used to predict survival after radical prostatectomy in patients with high-risk prostate cancer. Future study with larger cohort and long-term follow-up is required to confirm this finding.Materials and methodsA total of 295 patients with high-risk prostate cancer scheduled to undergo radical prostatectomy were prospectively enrolled from 2008 to 2016. Nested reverse transcription polymerase chain reaction was used to detect cells with PSCA mRNA in peripheral blood. The predicting ability of PSCA mRNA positivity for biochemical recurrence, overall survival, and cancer-specific survival after radical prostatectomy was evaluated.
Highlights
Prostate cancer (PC) is the second most common cancer in men and the fifth leading cause of cancer-related death worldwide [1]
Kaplan–Meier analysis revealed significant differences in biochemical recurrence, overall survival, and cancer-specific survival according to prostate stem cell antigen (PSCA) mRNA positivity
Cox regression hazards model analysis showed that PSCA mRNA positivity was an independent predictor of biochemical recurrence, overall survival, and cancer-specific survival
Summary
Prostate cancer (PC) is the second most common cancer in men and the fifth leading cause of cancer-related death worldwide [1]. In the United States of America, PC is the second leading cause of cancer-specific deaths in men, and approximately 26,120 PC-related deaths occurred in 2016 [2]. In clinically localized PC, patients harboring www.oncotarget.com high-risk disease exhibit adverse treatment outcomes [3]. This subset of patients is exposed to a greater risk of biochemical recurrence (BCR) or micrometastasis after radical prostatectomy (RP) compared with patients with low- or intermediate-risk disease. Multidisciplinary and multimodal therapeutic approaches have been applied for the management of patients with high-risk PC [4]. In the era of precision medicine, selecting patients who will benefit most from RP in high-risk PC is essential
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