No abstract

Radical laparoscopic salvage prostatectomy is a complex technique that seems to allow attaining high and long-lasting rates of biochemical remission in patients with local postradiotherapy recurrence. Although there is less morbidity in our series in comparison with the anastomotic stenosis and rectal injuries rate published in radical retropubic salvage prostatectomy, more extensive comparative studies are required to confirm this fact.

Objective: To evaluate the clinical utility of using the real-time reverse transcriptase-polymerase chain reaction (RT-PCR) to quantify prostate-specific antigen (PSA) mRNA in peripheral blood samples from patients with prostate cancer as a predictor of extraprostatic extension of the disease and to assess any correlations with known predictive markers of this condition. Methods: Immediately before radical prostatectomy, peripheral blood samples were taken from 42 men with clinically localized prostate cancer and analysed for PSA and 18S ribosomal (endogenous control) genes using real-time RT-PCR (with gene expression assays and the comparative C T -cycle threshold-method for quantifing). A total of 30 healthy male blood donors aged o50 y was taken as a control group.The relationships between PSA mRNA values, pathological and clinical features were analysed. PSA mRNA value, PSA level and biopsy Gleason score were then compared as predictors of extraprostatic extension. Results: PSA gene expresion was 3.73 times significantly higher in patients with clinically localized prostate cancer than in healthy men (Po0.05). There was no relationship between PSA real-time RT-PCR values and pathological stage pT2 or pT3 (P ¼ 0.5), and no association between PSA mRNA value and serum PSA level (P ¼ 0.9) or the Gleason score of the preoperative biopsy (P ¼ 0.9). Conclusion: There was no significant advantage in using the real-time RT-PCR assay of PSA mRNA before surgery to stage prostate cancer and to discriminate between organ-confined and extraprostatic extension.