title: Elimination of primary circulating prostate cells after radical prostatectomy for prostate cancer decreases the risk of future biochemical failure.
abstract: OBJECTIVE
  Primary CPCs are those detected in the blood of prostate cancer patients before radical treatment; secondary CPCs are those detected afterwards. Although primary CPCs are frequently found, it has been suggested that only a few will survive and go on to form metastasis. We evaluate the frequency of primary and secondary CPC detection and the association with biochemical failure, relation with clinical-pathological parameters and clinical implications in men treated by radical prostatectomy (RP) for prostate cancer.
  
  
  METHODS
  Serial blood samples were taken before surgery and during follow up after RP. Mononuclear cells were obtained by differential gel centrifugation, and CPCs were identified using standard immunocytochemistry using anti-PSA monoclonal antibodies. Age, pathological stage (organ confined, non organ confined), pathological grade, margin status (positive, negative), extracapsular extension, perineural, vascular, and lymphatic infiltration (positive, negative) were compared with the presence/absence of CPCs in patients with and without biochemical failure. Kaplan Meier method was used to compare the unadjusted biochemical failure free survival of patients with and without CPCs.
  
  
  RESULTS
  138 of 423 (32.6%) men undergoing prostate biopsy for an elevated serum PSA were diagnosed of prostate cancer. Of these men 15 (10.9%) were CPC negative. 95 CPC positive men underwent RP. There was no relation between primary CPC detection and clinical-pathological parameters; however, secondary CPCs were associated both with clinical-pathological parameters and biochemical failure.
  
  
  CONCLUSIONS
  Primary CPCs are frequently detected in men with prostate cancer, but they are not associated with biochemical failure, so that they may be useful for prostate cancer detection but not for prognosis. The persistence of CPCs after surgery is associated with increased biochemical failure.
authors.affiliation: Division of Medicine. Hospital de Carabineros de Chile. Nunoa. Santiago. Chile. Instituto de Bio-Oncología. Providencia. Santiago. Chile.Circulating Tumor Cell Unit. Faculty of Medicine. Universidad Mayor. Las Condes. Santiago. Chile.
authors.forename: Nigel P
authors.initials: NP
authors.lastname: Murray
authors.forename: Eduardo
authors.initials: E
authors.lastname: Reyes
authors.forename: Nelson
authors.initials: N
authors.lastname: Orellana
authors.forename: Cynthia
authors.initials: C
authors.lastname: Fuentealba
authors.forename: Ricardo
authors.initials: R
authors.lastname: Dueñas
mesh_terms: D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local; D009360:Neoplastic Cells, Circulating; D011379:Prognosis; D011446:Prospective Studies; D017430:Prostate-Specific Antigen; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery; D017211:Treatment Failure
chemical_list: D017430:Prostate-Specific Antigen