Disseminated tumor cells in bone marrow following definitive radiotherapy for intermediate or high-risk prostate cancer

Prostate. 2008 Nov 1;68(15):1607-14. doi: 10.1002/pros.20826.


Background: The purpose of this study was to explore the prevalence of disseminated tumor cells (DTCs) in bone marrow (BM) of clinically progression-free prostate cancer (PC) patients at least 2 years after curatively intended radiotherapy (RT) with or without adjuvant hormone treatment.

Methods: All patients were T(1-3)N(0)M(0) with intermediate or high risk of progression. Median time from RT to BM sampling was 5 years (2-8). A standardized immunocytochemical method applying the anticytokeratin antibodies AE1/AE3 was used for DTCs detection in 130 patients. Morphological characterization of immunostained cells was performed to exclude false positive cells. The post-treatment BM was explored in relation to pre-treatment risk factors, treatment strategy and serum levels of Testosterone and PSA at the time of BM sampling. Longitudinal changes in BM status were studied in a sub-group of 109 patients who also had donated BM prior to treatment.

Results: Post-treatment BM-aspirates were positive for DTCs in 17% of cases without correlation to any of the tested variables. Out of 14 patients who had DTCs in BM prior to treatment, all but one had become post-treatment negative. Out of 95 patients with pre-treatment negative BM status, 18 (19%) had become post-treatment positive.

Conclusions: DTCs in BM were found in 17% of clinically progression-free PC patients following RT. The detection of these cells may provide PSA-independent prognostic information remaining to be explored by prolonged follow-up.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Bone Marrow / pathology*
  • Disease Progression
  • Humans
  • Immunohistochemistry / methods
  • Male
  • Middle Aged
  • Prognosis
  • Prostatic Neoplasms / pathology*
  • Prostatic Neoplasms / radiotherapy*
  • Risk Assessment
  • Staining and Labeling
  • Time Factors