Biochemical staging of prostate cancer

The ability to stage prostate cancer and predict response to therapy has improved dramatically over the last 3 decades. Nevertheless, there is still a need for new biochemical markers that will improve the ability to predict an individual patient's stage and response to therapy. Because of the heterogeneity of prostate cancer, it is unlikely that a single biochemical marker that is capable of accurately staging all prostate cancer patients will be found. For this reason, nomograms that are capable of integrating various parameters to predict stage and prognosis will remain indispensable. As new biochemical markers that provide independent predictive information about stage or prognosis are identified, they can be incorporated into currently available nomograms. This article reviews various established and new biochemical markers for prostate cancer staging and prediction of response to therapy, the most promising of which are interleukin 6 soluble receptor and transforming growth factor beta(1). Incorporating these biochemical markers into a preoperative nomogram designed to predict PSA recurrence improved the ability to predict biochemical recurrence by a statistically and clinically significant margin.