title: Secondary circulating prostate cells predict biochemical failure in prostate cancer patients after radical prostatectomy and without evidence of disease.
abstract: BACKGROUND
  Although 90% of prostate cancer is considered to be localized, 20%-30% of patients will experience biochemical failure (BF), defined as serum PSA >0.2 ng/mL, after radical prostatectomy (RP). The presence of circulating prostate cells (CPCs) in men without evidence of BF may be useful to predict patients at risk for BF. We describe the frequency of CPCs detected after RP, relation with clinicopathological parameters, and association with biochemical failure.
  
  
  METHODS
  Serial blood samples were taken during followup after RP, mononuclear cells were obtained by differential gel centrifugation, and CPCs identified using standard immunocytochemistry using anti-PSA monoclonal antibodies. Age, pathological stage (organ confined, nonorgan confined), pathological grade, margin status (positive, negative), extracapsular extension, perineural, vascular, and lymphatic infiltration (positive, negative) were compared with the presence/absence of CPCs and with and without biochemical failure. Kaplan Meier methods were used to compare the unadjusted biochemical failure free survival of patients with and without CPCs.
  
  
  RESULTS
  114 men participated, and secondary CPCs were detected more frequently in patients with positive margins, extracapsular extension, and vascular and lymphatic infiltration and were associated with biochemical failure independent of these clinicopathological variables, and with a shorter time to BF.
  
  
  CONCLUSIONS
  Secondary CPCs are an independent risk factor associated with increased BF in men with a PSA <0.2 ng/mL after radical prostatectomy, but do not determine if the recurrence is due to local or systemic disease. These results warrant larger studies to confirm the findings.
authors: Division of Medicine, Hospital de Carabineros de Chile, Simón Bolívar 2200, Ñuñoa, 7770199 Santiago, Chile. nigelpetermurray@gmail.com
authors: Nigel P
authors: NP
authors: Murray
authors: Eduardo
authors: E
authors: Reyes
authors: Nelson
authors: N
authors: Orellana
authors: Cynthia
authors: C
authors: Fuentealba
authors: Leonardo
authors: L
authors: Bádinez
authors: Ruben
authors: R
authors: Olivares
authors: José
authors: J
authors: Porcell
authors: Ricardo
authors: R
authors: Dueñas
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D002677:Chile / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D015995:Prevalence; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000601:surgery*; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen
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