Test Predicts Prostate Cancer Recurrence

A new prognostic test can help determine whether a prostate cancer patient will have a recurrence of the disease, even if surrounding lymph nodes initially appear negative for cancer, according to a study by researchers the University of Southern California (USC, Los Angeles, USA).

The test "appears to be a very powerful test and better than anything else we know of for predicting recurrence,” said Richard Cote, professor of pathology and urology in the Keck School of Medicine of USC. Patients whose disease is caught in the early stages will do very well, said Prof. Cote.

Cote and his colleagues looked at 3,914 lymph nodes from 180 patients who were staged as having lymph nodes negative for cancer based on standardized histologic evaluation. The lymph nodes were then evaluated for occult metastases using new specific immunohistochemistry tests that can detect cancer on a cell-by-cell level.

The new analysis checks for cells that react with antibodies to cytokeratins and prostate-specific antigen (PSA). The team's testing found occult tumor cells in the lymph nodes of 24 patients whose lymph nodes previously had been diagnosed as cancer-free.

The group then compared cancer recurrence and survival in those patients with the hidden tumor cells versus those without the cells. The presence of occult tumor cells was associated with increased prostate cancer recurrence and decreased survival. In fact, "the outcome for patients with occult tumor cells was similar to those who were identified as having positive lymph nodes at the time of the surgery,” noted Prof. Cote.

Current trials also are using the test to find hidden metastases in lymph nodes and bone marrow for breast and lung cancers. The study appeared in the June 2006 Journal of Clinical Oncology.




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