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Micrometastases of Bone Marrow in Localized Prostate Cancer: Correlation With Established Risk Factors

From the Urologische Klinik and II Medizinische Klinik, Zentralklinikum Augsburg, Augsburg, and Institut für Immunologie der Universität München, Munich, Germany.

Address reprint requests to Dorothea Weckermann, MD, Urologische Klinik, Zentralklinikum Augsburg, Stenglinstr 2, 86156 Augsburg, Germany

PURPOSE: The presence of cytokeratin 18–positive cells in bone marrow correlates with conventional risk factors in many tumors. We examined whether this was also valid for localized or lymphatically spread prostate cancer.

PATIENTS AND METHODS: Immediately before radical prostatectomy, bone marrow aspirates from both sides of the iliac crest were taken from 287 patients. The presence of cells containing cytokeratin 18 was interpreted as micrometastasis.

RESULTS: In patients with negative lymph nodes (n = 219), conventional risk factors (Gleason score, pathologic stage, ploidy, and preoperative prostate-specific antigen) did not correlate with the preoperative detection of cells containing cytokeratin 18. There was also no correlation with lymph node metastases. Furthermore, there was no interdependency between the preoperatively detected number of cells and the established risk factors.

CONCLUSION: We assume the presence of epithelial cells in bone marrow to be an independent parameter, the clinical importance of which must be substantiated by further studies.

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