Molecular staging of prostate cancer: Dream or reality?

The reverse transcriptase-polymerase chain reaction (RT-PCR) assay is an ex tremely sensitive technique for the defection of circulating cells expressi ng prostate-specific antigen (PSA) in prostate cancer patients. This articl e reviews the literature on the use of this technique as a preoperative par ameter to predict both extraprostatic disease and PSA recurrence after radi cal prostatectomy. Despite the relative consensus regarding the increase in RT-PCR-positivity with tumor stage (ie, clinically localized vs metastatic prostate cancer), the use of RT-PCR as a clinical staging modality is cont roversial. To date, more than 16 institutions have evaluated the RT-PCR tes t in prostate cancer, Of these institutions, only two have reported the uti lity of RT-PCR ns a staging modality and three have reported the utility of the test in predicting PSA recurrence. Before further conclusions ape draw n regarding the clinical utility of RT-PCR in prostate cancer patients and its routine use is advocated, a larger patient population needs to be studi ed and followed for longer periods.