Early Postoperative Plasma Transforming Growth Factor-beta1 Is A Strong Predictor Of Biochemical Progression After Radical Prostatectomy

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Cancer / Oncology;  Clinical Trials / Drug Trials
Article Date: 19 Apr 2008 - 0:00 PDT

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UroToday.com - A multi-institution report that appears in the online version of Urology suggests that post-radical prostatectomy (RP) plasma levels of transforming growth factor β-1 (TGF β-1) predict for biochemical recurrence (BR).

The authors evaluated TGFβ-1, IL-6 and its soluble receptor IL6sR, all which are associated with aggressive prostate cancer (CaP) with occult metastases present at primary treatment with eventual disease progression. Between 1997 and 2000 postoperative plasma levels of TGFβ-1, IL-6 and IL6sR were collected at 6-8 weeks following RP. Patients had clinical and PSA follow-up for CaP recurrence. The biomarkers were assayed by immunoassay. A total of 291 men were included and median follow-up was 4.2 years.

Biochemical progression occurred in 59 patients (20.3%) and biochemical progression-free survival probability 3 and 5 years after surgery was 79.3% and 70.7%, respectively. TGFβ-1 was associated with biochemical progression after RP, but IL-6 and IL-6sR were not. TGFβ-1 was the most informative predictor followed by pathological Gleason sum and preoperative PSA. A model relying only on pathological characteristics resulted in a c-index of 78.4% for predicting biochemical recurrence. This increased to 84.1% with the addition of TGFβ-1. The addition of IL-6 or IL-6sR did not improve the c-index. The use of all 3 biomarkers resulted in an inferior accuracy to use of TGFβ-1 alone. Postoperative plasma TGFβ-1 levels were significantly higher in men with features of aggressive disease progression compared to those with features of non-aggressive disease progression. Levels of IL-6 and IL-6sR were not different between these 2 groups.

The addition of TGFβ-1 levels after RP increases the accuracy of nomograms for predicting disease recurrence.

Reported by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

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