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Preoperative Plasma Endoglin Levels Predict Biochemical Progression After Radical Prostatectomy

Authors' Affiliations: ¹ Department of Urology, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas; ² Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Quebec, Canada; and ³ Baylor Prostate Center, The Scott Department of Urology,Baylor College of Medicine, Houston, Texas

Requests for reprints: Shahrokh F. Shariat, Department of Urology, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9110. Phone: 469-363-8500; Fax: 214-648-8786; E-mail: Shahrokh.Shariat{at}UTSouthwestern.edu.

Purpose: Endoglin (CD105) is a transmembrane glycoprotein expressed by human vascular endothelial cells thought to play a pivotal role in endothelial cell proliferation. The aim of this study was to evaluate the association of preoperative plasma endoglin levels with established clinical and pathologic features of prostate cancer and disease progression after radical prostatectomy.

Experimental Design: Preoperative plasma endoglin levels were measured in 425 patients who underwent radical prostatectomy for clinically localized prostate cancer using a commercially available ELISA assay. Multivariate logistic regression was used to test the association of plasma endoglin levels with biochemical progression after radical prostatectomy.

Results: Median follow-up for patients alive at the time of analysis was 36.8 months (interquartile range, 44.1). Of 425 patients, 77 patients (18.1%) experienced biochemical progression after radical prostatectomy. Preoperative plasma endoglin levels were significantly elevated in patients with higher preoperative total serum prostate-specific antigen (P < 0.001) and adverse pathologic features. Preoperative plasma endoglin was an independent predictor of biochemical progression after surgery after adjusting for the effects of standard preoperative and postoperative features (P < 0.001 and P = 0.026, respectively).

Conclusions: Preoperative plasma endoglin levels are associated with established features of advanced prostate cancer. More importantly, higher preoperative plasma endoglin levels are independent predictors of an increased risk of biochemical progression in patients treated with radical prostatectomy and bilateral pelvic lymphadenectomy.