Prognostic prediction following radical prostatectomy for prostate cancer using conventional as well as molecular biological approaches

Abstract

Abbreviations & Acronyms %fPSA = percent free PSA bGG = biopsy Gleason grade bGS = biopsy Gleason sum BR = biochemical recurrence cT = clinical stage ECE = extracapsular extension BR = biochemical recurrence HSP = heat shock protein IL = interleukin KLK2 = kallikrein-related peptidase-2 LNI = lymph node invasion NA = not available PC = prostate cancer PCA3 = prostate cancer antigen-3 pcpbc = % of cancer in positive biopsy core ppbc = % of positive biopsy core PSA = prostate-specific antigen pT = pathological stage RP = radical prostatectomy RT = radiation therapy SMS = surgical margin status SVI = seminal vesicle invasion TGF-b1 = transforming growth factor-b1 Abstract: Although radical prostatectomy has been the mainstay of treatment for men with clinically organ-confined prostate cancer, a certain proportion of men undergoing radical prostatectomy fail to achieve a complete cure of this disease; that is, postoperative biochemical recurrence develops in approximately 30% of men, some of whom will ultimately die of disease progression. A number of studies, therefore, have been carried out to identify factors reflecting prognostic outcomes following radical prostatectomy, which would be potentially helpful for properly counseling individual patients undergoing this surgery. Furthermore, various types of model systems using multiple clinicopathological parameters, such as the nomogram, look-up table and artificial neural network, have been shown to have better performance in postoperative prognostic prediction than the opinions of expert clinicians. However, there have not been any standard models uniformly applied to postoperative prognostic prediction, which could be explained, at least in part, by the use of conventional clinicopathological parameters alone, suggesting the need for the additional evaluation of molecular markers simultaneously considering the unique biological features of prostate cancer. In this review, a search of the literature was carried out focusing on the significance of prognostic models following radical prostatectomy, and it is suggested that these models could be promising tools to provide accurate information on the postoperative clinical course of prostate cancer patients. To widely introduce such models into clinical practice, it is necessary to further improve currently available models and develop more reliable, flexible, simple and easily accessible tools by incorporating conventional clinicopathological factors as well as molecular biomarkers.

Protocadherin B9 promotes resistance to bicalutamide and is associated with the survival of prostate cancer patients

“…In the multivariate model, the protocadherin B9 expression was an independently associated with PSA relapse-free survival (HR 2.08; 95%CI: 1.01-4.71 P = 0.046; Table 2) as well as the preoperative PSA concentration, pT classification and Gleason score, which are well known prognostic factors. 18 Collectively, the above findings indicate that the high expression of protocadherin B9 may be a novel marker to identify PCa patients with PSA recurrence after radical prostatectomy.…”

miR-1 and miR-133b Are Differentially Expressed in Patients with Recurrent Prostate Cancer

“…Currently, primary tumor stage, serum PSA level, and biopsy Gleason grade are utilized during clinical assessment to predict the pathologic stage of the tumor and the treatment efficiency, however, none or even a combination of these indicators are sufficient to reliably anticipate outcome for patients [3], [4]. A consensus criteria on the definition of biochemical recurrence based on PSA levels, has not been well established, which prevents the establishment of a standard prognostic model in men treated with radical prostatectomy [18]. Besides, detection of PSA in the sera of PCa patients after radical prostatectomy might be due to the presence of residual benign prostate tissue, which misguides practitioners to come up with a false positive diagnosis [19].…”

“…For example, various genes, which are specifically detected in the prostate gland, such as human KLK2, PCA3, prostate-specific membrane antigen and prostate stem cell antigen were suggested as useful prognostic markers for prediction of pathological features in PCa patients [23]. Altered expressions of Bcl-2 and Bax were also associated with subsequent development of biochemical recurrence [18]. However, among the genes proposed as prognostic biomarker depending on large-scale gene expression profiling studies, only a few genes could be validated in multiple studies [24].…”

Association of Tissue mRNA and Serum Antigen Levels of Members of the Urokinase-Type Plasminogen Activator System with Clinical and Prognostic Parameters in Prostate Cancer

“…Several biomarkers for PCa have been described either in tumor tissue or urine [2, 3]. However, further research and validation of these molecular markers for diagnostic and prognostic purposes in PCa patients are still necessary.…”