Molecular staging of surgical margins after radical prostatectomy by detection of telomerase activity

Background. The further course of prostate cancer (PC) after radical prosta tectomy (RPX) is decisively influenced by the local tumor stage. Although i t is thus far possible to assess the risk of local recurrence from the path ohistology, precise predictions cannot be made. A more precise evaluation w ould be desirable, mainly for early planning of adjuvant therapy. Other aut hors have shown that telomerase activity may be a marker for malignant pote ntial. We assessed the detection of telomerase activity using the telomeric repeat amplification protocol (TRAP) in surgical margins compared to conve ntional histopathological examination. Methods. Ninety-two patients with local PC who underwent RPX were examined. After RPX biopsies were obtained from four defined areas of the prostatic fossa and processed by TRAP assay for telomerase activity using a standard protocol. Results. In 5 of 48 patients (10.4%) with organ-confined prostate carcinoma (pT2) telomerase activity could be detected. Seven of 47 patients (14.9%) with locally advanced PC (>pT2) had at least one positive specimen. Conclusions. The results obtained in our study indicate that detection of t elomerase activity by TRAP assay may be a suitable parameter for molecular staging of surgical margins, because of the high tumor-specificity. Further follow-up must clarify whether patients with positive molecular detection have an increased risk of local recurrence. Prostate 49: 140-144, 2001. (C) 2001 Wiley-Liss, Inc.