At present, there are limited methods for assessing the prognosis of prostate cancer at the time of diagnosis. In a recent issue of Archives of Internal Medicine, researchers from the Veterans Affairs Healthcare System in New England report that certain molecular markers may be associated with an increase in the long-term risk for death from prostate cancer.

The researchers examined the medical records and tissues biopsies of 1172 men with prostate cancer to determine whether molecular markers of cell cycle regulation and angiogenesis (or, new blood vessel growth) are associated with increased long-term risk for death. Among the patients studied, the average age at the time of prostate cancer diagnosis was 72 years and the average prostate-specific antigen (PSA) level was 10.0 µg/L. During 11 to 16 years of follow-up, 842 of the men died and 181 of these deaths were attributed to prostate cancer. When looking at molecular markers, the researchers found that markers known as bcl-2, p53, and microvessel density were associated with death from prostate cancer.

These findings suggest that molecular markers may assist in identifying aggressive prostate cancers, but confounding factors such as family history were not evaluated in this study. What is needed are additional studies assessing whether molecular features that are associated with an increased risk for prostate cancer death are clinically useful in identifying patients who might benefit from medical interventions to reduce mortality.

Source:

Ann Intern Med. 2009;150:595-603.