Clinical and molecular followup after radical retropubic prostatectomy

Purpose: We previously reported evidence of hematogenous dissemination of p rostate cells during radical retropubic prostatectomy, and we now provide c linical and molecular reverse transcriptase-polymerase chain reaction (RT-P CR) followup of that patient cohort. Materials and Methods: A total of 101 men with clinically localized prostat e cancer were prospectively enrolled in the study. The prostate specific an tigen (PSA) RT-PCR assay was performed on peripheral venous blood samples p reoperatively in 101, during surgery in 29, during and up to 12 weeks after surgery in 50 and at least 1 year postoperatively in 65 patients. Correlat ion with clinical (PSA) indicators of recurrence was performed. Results: Of the 101 patients 9 demonstrated biochemical evidence of prostat e cancer progression (median followup 22 months). Of the 50 men with periop erative molecular results the RT-PCR positive rate increased from 22% preop eratively in 11 to 48% in 24 (p = 0.02) and then decreased to 10% in 4 of 4 0 men at 1 year postoperatively (p = 0.07). Molecular followup at a minimum of 1 year after radical retropubic prostatectomy was obtained in 65 men, o f whom the RT-PCR positive rate decreased from 23% preoperatively in 14 to 9.2% in 6 (p = 0.05). No significant correlation was observed between a per sistently positive RT-PCR result and biochemical failure. Conclusions: Although a significant proportion of men have molecular eviden ce of hematogenous prostate cell dissemination intraoperatively, longitudin al molecular and clinical followup demonstrates reconversion to a negative status as the predominant trend. At relatively short followup no significan t correlation was identified between the RT-PCR result and the PSA progress ion-free survival.