Perioperative changes in TGF-ß1 levels predict the oncological outcome of cryoablation-receiving patients with localized prostate cancer.

PURPOSE: To evaluate the cytokine transforming growth factor beta 1 (TGF-ß1) as a predictor of oncological outcomes in patients after cryoablation. MATERIALS AND METHODS: Perioperative blood samples from prostate cancer (PC) patients who underwent total gland cryoablation between October 2011 and March 2013 were collected prospectively. Plasma TGF-ß1 levels were quantified using magnetic bead immunoassay. The perioperative change in TGF-ß1 was defined as the change in TGF-ß1 from before surgery to 1-2 months after surgery. Biochemical recurrence (BCR) was defined according to the Phoenix criteria. The Mann-Whitney U, Kruskal-Wallis rank sum, and Chi-square test were used to compare the clinical characteristics of the subsets. The Cox proportional hazard model was applied for the comparison of recurrence risk among the groups. RESULTS: A total of 75 PC patients were included. During a median follow-up period of 12 months (range: 2.5-47 months), 11 patients had BCR, and 64 patients did not. Significantly greater changes in the perioperative TGF-ß1 levels (median: 470.3 vs. 78.9 pg/ml) were observed in patients with than without BCR (p < 0.05). According to the changes in TGF-ß1 levels, the patients were further divided into 4 groups, which were determined in the quartile categories of perioperative TGF-ß1 levels. Group 4 (≥430) predicted the worst BCR outcome. CONCLUSIONS: Perioperative plasma TGF-ß1 levels were associated with BCR after prostate cryoablation for localized PC. Increase in postoperative plasma TGF-ß1 may be a novel predictor for poor oncological outcomes and prompt a more aggressive follow-up or earlier salvage treatment.