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ERG expression is associated with increased risk of biochemical relapse following radical prostatectomy in early onset prostate cancer

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Abstract

Purpose

ERG expression has been proposed to signify molecular subtype of PCA. However, its significance in early onset prostate cancer (PCA) is not characterized.

Materials and methods

ERG protein expression was investigated in a cohort of 121 men diagnosed with localized PCA at <50 years of age with a mean follow-up time of 65.7 months. ERG was correlated to patients’ outcome and clinical-pathological parameters using univariate and multivariate analysis.

Results

ERG expression was detected in 76/118 (64.4 %) analyzable patients’ samples and showed interfocal heterogeneity (differences between foci) in 17/118 (14.4 %) patients. There was significant association between ERG expression and Gleason score (p = 0.022), but not with any other clinical-pathologic parameter, including pre-surgical PSA levels, tumor volume, pathological stage, surgical margin or lymph-vascular invasion. ERG had significant effect on the rate of biochemical relapse following radical prostatectomy, with ERG positive patients showing higher relapse rates vs. ERG negative patients (p = 0.007). However, considering time till biochemical relapse post-radical prostatectomy, ERG expression showed positive insignificant trends (p = 0.071). Notably, and of great significance, in this cohort of early onset disease, none of the ERG negative PCA patients exhibited biochemical relapse.

Conclusion

The study results suggest that ERG expression may be of added prognostic value in localized prostate cancer in patients with early onset PCA. However, the issue of ERG interfocal heterogeneity observed may require the evaluation of several tumor foci to assess ERG status per case. Incorporating ERG status into existing nomograms may be of added prognostic value in patients with early onset PCA.

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Acknowledgments

The authors would like to thank Shuhong Liu for technical support and Samar Hegazy for scientific input. This work was supported by the Young Investigator Award of the Prostate Cancer Foundation, USA, Prostate Cancer Canada, and is proudly funded by the Movember foundation, Grant #B-2013-01. The work was also supported by internal grant from Calgary Laboratory Services (RS09-530).

Conflict of interest

The authors have no conflict of interest to declare in this study.

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Authors and Affiliations

  1. Department of Pathology and Laboratory Medicine, University of Calgary and Calgary Laboratory Services, Calgary, Alberta, Canada

    K.-C. Huang, M. Dolph & T. A. Bismar

  2. Department of Urology, University of Calgary, Calgary, Alberta, Canada

    B. Donnelly

  3. Departments of Oncology, Biochemistry and Molecular Biology, University of Calgary, Calgary, Alberta, Canada

    T. A. Bismar

  4. Southern Alberta Cancer Institute and Tom Baker Cancer Center, Calgary, Alberta, Canada

    T. A. Bismar

  5. The Prostate Cancer Center, Calgary, Alberta, Canada

    B. Donnelly & T. A. Bismar

  6. Rockyview General Hospital, Calgary, Alberta, T2V 1P9, Canada

    T. A. Bismar

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  1. K.-C. Huang
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  2. M. Dolph
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Correspondence to T. A. Bismar.

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Huang, KC., Dolph, M., Donnelly, B. et al. ERG expression is associated with increased risk of biochemical relapse following radical prostatectomy in early onset prostate cancer. Clin Transl Oncol 16, 973–979 (2014). https://doi.org/10.1007/s12094-014-1182-x

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  • DOI: https://doi.org/10.1007/s12094-014-1182-x

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