The quantification of PSA mRNA copies in pathologically normal pelvic lymph nodes is a viable prognostic indicator

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Abstract
Localized prostate cancer is a disease associated with significant biochemical recurrence with rising serum prostate-specific antigen (PSA) levels and marked progression. More specific prognostic methods are needed to identify the occult micrometastases that lead to biochemical recurrence. Ferrari et al report on the technique of quantifying pathologically occult metastases in pelvic lymph nodes via PCR quantification. The group reports statistically significant biochemical failure-free recurrence in the comparison of 100 or greater normalized PSA mRNA copies (PSA-N) versus PSA-N of less than 100 at a median follow up of 4 years. PSA-N quantification appears to be an important method for predicting biochemical recurrence and characterizing the recurrence risk of localized prostate cancer patients with pathologically normal pelvic lymph nodes. This method warrants further investigation in prospective trials.