Preoperative plasma levels of transforming growth factor beta(1) (TGF-beta(1)) strongly predict progression in patients undergoing radical prostatectomy

Purpose: Elevated local and circulating levels of transforming growth facto r beta, (TOF-beta (1)) have been associated with prostate cancer invasion a nd metastasis. We tested the hypothesis that preoperative plasma TGF-beta ( 1) levels would independently predict cancer stage and prognosis in patient s who undergo radical prostatectomy. Patients and Methods: The study group consisted of 120 consecutive patients who underwent radical prostatectomy for clinically localized prostate canc er (median follow-up, 53.8 months), Preoperative plasma levels of TGF-beta (1) were measured and correlated with pathologic parameters and clinical ou tcomes. TOF-beta (1) levels also were measured in 44 healthy men without ca ncer, in 19 men with prostate cancer metastatic to regional lymph nodes, an d in 10 men with prostate cancer metastatic to bone. Results: Plasma TGF-beta (1) levels in patients with lymph node metastases (14.2 +/- 2.6 ng/mL) and bone metastases (15.5 +/- 2.4 ng/mL) were higher t han those in radical prostatectomy patients (5.2 +/- 1.3 ng/mL) and healthy subjects (4.5 +/- 1.2 ng/mL) (P < .001), In a preoperative analysis, preop erative plasma TGF-beta, level and biopsy Gleason sum both were predictors of organ-confined disease (P = .006 and P = ,006, respectively) and PSA pro gression (P < .001 and P = .021, respectively). In a postoperative multivar iate analysis, preoperative plasma TGF-beta (1) level, pathologic Gleason s um, and surgical margin status were predictors of PSA progression (P = .020 , P = .020, and P = .022, respectively). In patients who progressed, preope rative plasma TGF-beta (1) levels were higher in those with presumed distan t compared with local-only failure (P = .019), Conclusion: Plasma TGF-beta (1) levels are markedly elevated in men with pr ostate cancer metastatic to regional lymph nodes and bone. In men without c linical ar pathologic evidence of metastases, the preoperative plasma TGF-b eta (1) level is a strong predictor of biochemical progression after surger y, presumably because of an association with occult metastatic disease pres ent at the rime of radical prostatectomy.