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The Scientific World Journal
Volume 2013, Article ID 762064, 7 pages
http://dx.doi.org/10.1155/2013/762064
Clinical Study

Secondary Circulating Prostate Cells Predict Biochemical Failure in Prostate Cancer Patients after Radical Prostatectomy and without Evidence of Disease

1Division of Medicine, Hospital de Carabineros de Chile, Simón Bolívar 2200, Ñuñoa, 7770199 Santiago, Chile
2Instituto de Bio-Oncología, Avenida Salvador 95, Oficina 95, Providencia, 7500710 Santiago, Chile
3Circulating Tumor Cell Unit, Faculty of Medicine, Universidad Mayor, Renato Sánchez 4369, Las Condes, 7550224 Santiago, Chile
4Faculty of Medicine, Universidad Diego Portales, Manuel Rodriguez Sur 415, 8370179 Santiago, Chile
5Urology Division, Hospital de Carabineros de Chile, Simón Bolívar 2200, Ñuñoa, 7770199 Santiago, Chile
6Foundation Arturo Lopez Perez, Rancagua 899, Providencia, 7500921 Santiago, Chile
7Division of Medicine, Hospital de Carabineros de Chile, Simón Bolívar 2200, Ñuñoa, 7770199 Santiago, Chile

Received 6 December 2012; Accepted 10 March 2013

Academic Editors: Volkan Tugcu and Murat Tunc

Copyright © 2013 Nigel P. Murray et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. 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 and Patients. 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.