Outcome study of patient (pts) with localized prostate cancer (PC) staged by reverse transcription quantitative real-time-PCR (QRT-PCR) analysis of prostate specific antigen (PSA) mRNA levels in pathologically normal (NO) pelvic lymph nodes (PLN)

4583 Background: PC recurs in 1/3 of pts after local treatment indicating micrometastases are frequently undetected. Based on established risk factors (RF) for recurrence - tumor stage (T), serum PSA (sPSA) and biopsy Gleason score (GL), pts are stratified in low (T≤2A + PSA 20 or GL>7) risk. Although helpful, quantification of PSA mRNA in high-risk N0 PLN pts might identify those with prognostically-relevant tumor loads of metastases whose potential benefit from early systemic therapy would override its morbidity. Methods: Bilateral N0 PLN of 341 PC pts undergoing radical prostatectomy (RP) or radiation (XRT) were prospectively collected with baseline data and sPSA follow-up (f/u). In 318 cases, PSA mRNA copies were quantified by QRT-PCR. Duplicate test samples were adjusted to a fixed housekeeping gene transcript level that minimized false positives. We assessed whether a threshold PSA copy number (tPSA) was associated with pr...