Micrometastases of bone marrow in localized prostate cancer: Correlation with established risk factors

Purpose: The presence of cytokeratin 18-positive cells in bone marrow corre lates with conventional risk factors in many tumors. We examined whether th is wets also valid for localized or lymphatically spread prostate cancer. Patients and Methods: Immediately before radical prostatectomy, bane marrow aspirates from both sides of the iliac crest were taken from 287 patients. The presence of cells containing cytokeratin 18 wets interpreted as microm etastasis. Results: In patients with negative lymph nodes (n = 219), conventional risk factors (Gleason score, pathologic stage, ploidy, and preoperative prostat e-specific antigen) did not correlate with the preoperative detection of ce lls containing cytokeratin 18. There was also no correlation with lymph nod e metastases. Furthermore, there was no interdependency between the preoper atively detected number of cells and the established risk factors, Conclusion: We assume the presence of epithelial cells in bone marrow to be an independent parameter, the clinical importance of which must be substan tiated by further studies. (C) 1999 by American Society of Clinical Oncolog y.