Preoperative blood testing for seven biomarkers can accurately predict risk for development of recurrent or metastatic prostate cancer after radical prostatectomy, according to an article in the June 15 issue of Clinical Cancer Research.

"We have been looking at these biomarkers for the past 10 to 15 years in the laboratory, but now we can translate these findings into progress for the individual patient," said Shahrokh F. Shariat, MD, chief resident in urology at the University of Texas Southwestern Medical Center.

In the current study, researchers enrolled 423 patients underwent radical prostatectomy and bilateral lymphadenectomy.

Using commonly available blood tests, they measured levels of the following seven biomarkers: transforming growth factor-β1, interleukin-6, interleukin-6 soluble receptor, vascular endothelial growth factor, vascular cell adhesion molecule-1, endoglin, and urokinase plasminogen activator.

"We reviewed background literature on over 60 separate biomarkers and determined that these were the optimal seven that would have predictive value," Shariat said.

Patients were followed for approximately four years, with cancer recurrence noted in 17.7 percent of patients. Elevated levels of the seven biomarkers were associated with increased risk of relapse. For example, the presence of urokinase plasminogen inhibitor-1 increased risk by 37 percent, while the presence of vascular endothelial growth factor increased risk by 47 percent.

The combination of all seven biomarker variables accurately predicted risk 86.6 percent of cases observed through the follow-up period. In contrast, the multivariate model containing only standard clinical variables such as clinical stage, biopsy Gleason score and preoperative prostate-specific antigen level had an accuracy rate of 71.6 percent.

"This is a large and unique improvement for patient care. Neither preoperative magnetic resonance imaging nor any of the clinical features we have used before even comes close to this level of accuracy," Shariat said.