Evaluation of selected proinflammatory factors, angiogenesis and lymphangiogenesis as potential markers of early tumor recurrence in patients undergoing surgical treatment for prostate cancer

Abstract

Author(s): Kamecki Krzysztof, Biedka Marta*, Makarewicz Roman, Goralewska Alina and Jolanta Mrochem-Kwarciak

Introduction: Up to a half of patients after radical prostatectomy due to prostate cancer have biochemical recurrence, i.e., PSA concentrations >0.2 ng/ml. In most patients, biochemical recurrence does not significantly affect survival and quality of life; however, in about one third of patients, biochemical recurrence precedes a clinically relevant recurrence of prostate cancer. Usually, based on the current criteria of biochemical recurrence, prostate cancer recurrence is diagnosed several months after surgery. This delays adjuvant treatment and worsens treatment outcomes. This study aimed to check whether preoperative concentrations of markers of angiogenesis, lymphoangiogenesis, and extracellular matrix degradation could predict biochemical recurrence of prostate cancer after radical prostatectomy. Materials and methods: The study included 82 patients who underwent radical prostatectomy for prostate cancer (cT1-T2N0M0). Before surgery and 8-10 days after surgery, serum concentrations of PSA and markers of inflammatory processes, angiogenesis, lymphangiogenesis, and extracellular matrix degradation were measured (CRP, VEGF-A, VEGF-C, VEGF-D, TIMP-1, TIMP-2). The stage of prostate cancer was determined histopathologically (TNM classification, Gleason score) and clinically (digital rectal examination, prostate volume assed with ultrasound, pelvic magnetic resonance imaging). With the Kaplan-Meier analysis and Cox proportional hazard models, we checked whether the variables studied were associated with the risk of biochemical recurrence of prostate cancer after radical prostatectomy. Results: During a 3-year follow-up, 27 of 82 patients (32.9%) had biochemical recurrence of prostate cancer after radical prostatectomy. The risk of biochemical recurrence of prostate cancer was not significantly associated with patient age, BMI, result of preoperative prostate digital rectal examination, cancer stage assessed with pelvic magnetic resonance imaging, number of lymph nodes removed, and cancer grade on histopathology. The risk of biochemical recurrence of prostate cancer after radical prostatectomy was higher in patients with lower prostate volume on pre-operative transrectal ultrasound, higher Gleason score in preoperative and postoperative analyses, and positive surgical margins. The concentrations of the studied markers of inflammatory processes, angiogenesis, lymphangiogenesis, and remodeling of extracellular matrix were not related to the risk of biochemical recurrence of prostate cancer after radical prostatectomy.

Share this article