Gene Expression Correlates of Site-specific Metastasis Among Men With Lymph Node Positive Prostate Cancer Treated With Radical Prostatectomy: A Case Series

Predictors of site-specific metastasis after radical prostatectomy (RP) are unknown despite prognostic differences between metastatic sites. We performed RNA expression analysis for 19 genes known to be correlated with aggressive prostate cancer in primary tumors of 63 men pN+ at RP (N = 35 developing metastases after RP vs N = 28 without metastases after RP). Of the men developing metastases, 22 (62.9%) had bone metastases, 8 (22.9%) had nonregional nodal metastases, and 5(14.3%) had visceral metastases. Patients with nodal metastases had higher androgen receptor expression relative to other metastatic sites and nonmetastatic controls (P = .001). This may explain the favorable prognosis of nodal metastases as it may be more androgen dependent.