title: Prevalence and prognostic significance of TMPRSS2-ERG gene fusion in lymph node positive prostate cancers.
abstract: BACKGROUND
  TMPRSS2-ERG gene fusion is the most frequent genetic alteration in prostate cancer. However, information about its distribution in lymph node positive prostate cancers and the prognostic significance in these advanced tumors is unknown.
  
  
  METHODS
  Gene fusion status was determined by fluorescence in situ hybridization on a tissue-microarray constructed from 119 hormone-naïve nodal positive, surgically treated prostate cancers containing samples from the primary tumors and corresponding lymph node metastases. Data were correlated with various tumor features (Gleason score, stage, cancer volume, nodal tumor burden) and biochemical recurrence-free, disease-specific, and overall survival.
  
  
  RESULTS
  TMPRSS2-ERG fusion was detected in 43.5% of the primary tumors. Conversely, only 29.9% of the metastasizing components showed the fusion. Concordance in TMPRSS2-ERG status between primary tumors and metastases was 70.9% (Kappa 0.39); 20.9% and 8.1% of the patients showed the mutation solely in their primary tumors and metastases, respectively. TMPRSS2-ERG fusion was not correlated with specific histopathological tumor features but predicted favorable biochemical recurrence-free, disease-specific and overall survival independently when present in the primary tumor (P < 0.05 each).
  
  
  CONCLUSIONS
  TMPRSS2-ERG fusion is more frequent in primary prostate cancer than in corresponding metastases suggesting no selection of fusion-positive cells in the metastatic process. The gene fusion in primary tumors independently predicts favorable outcome.
authors.affiliation: Institute of Pathology, University of Bern, Switzerland.
authors.forename: Achim
authors.initials: A
authors.lastname: Fleischmann
authors.forename: Outi R
authors.initials: OR
authors.lastname: Saramäki
authors.forename: Inti
authors.initials: I
authors.lastname: Zlobec
authors.forename: Diana
authors.initials: D
authors.lastname: Rotzer
authors.forename: Vera
authors.initials: V
authors.lastname: Genitsch
authors.forename: Roland
authors.initials: R
authors.lastname: Seiler
authors.forename: Tapio
authors.initials: T
authors.lastname: Visakorpi
authors.forename: George N
authors.initials: GN
authors.lastname: Thalmann
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005500:Follow-Up Studies; D050939:Gene Fusion / Q000235:genetics*; D005838:Genotype; D006801:Humans; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology; D008207:Lymphatic Metastasis / Q000235:genetics* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D012189:Retrospective Studies; D012697:Serine Endopeptidases / Q000235:genetics* / Q000378:metabolism; D015996:Survival Rate; D046888:Tissue Array Analysis; D015534:Trans-Activators / Q000235:genetics* / Q000378:metabolism; D000071230:Transcriptional Regulator ERG
chemical_list: C072312:ERG protein, human; D015534:Trans-Activators; D000071230:Transcriptional Regulator ERG; D012697:Serine Endopeptidases; C421305:TMPRSS2 protein, human
keywords: TMPRSS2-ERG; metastases; prostate cancer; survival