Clinical and genomic analysis of XXXX progression with a background of  postoperative biochemical recurrence.

@entity1 @entity263 @entity66 @entity5 @entity342 @entity3 @entity1486
OBJECTIVE: To better characterize the genomics of @entity1 with biochemical recurrence (BCR) who have metastatic disease progression in order to improve treatment decisions for @entity263 . METHODS: The expression profiles of three clinical outcome groups after radical prostatectomy (RP) were compared: those with @entity66 ( @entity66 ; n = 108); those with BCR (rise in @entity1486 [PSA] level without @entity3 ; n = 163); and those with @entity3 (n = 192). The @entity1 were profiled using @entity1 Exon 1.0 ST microarrays, and outcomes were supported by a median 18  years of follow-up. A @entity3 signature was defined and verified in an independent RP cohort to ensure the robustness of the signature. Furthermore, bioinformatics characterization of the signature was conducted to decipher its biology. RESULTS: Minimal gene expression differences were observed between adjuvant treatment-na  ve @entity1 in the @entity66 group and @entity1 without @entity3 in the BCR group. More than 95% of the differentially expressed genes ( @entity3 signature) were found in comparisons between primary @entity5 of @entity3 @entity1 and the two other outcome groups. The @entity3 signature was validated in an independent cohort and was significantly associated with cell cycle genes, ubiquitin-mediated proteolysis, DNA repair, @entity342 , G-protein coupled and NOTCH signal transduction pathways. CONCLUSION: This study shows that @entity3 development after BCR is associated with a distinct transcriptional programme that can be detected in the primary @entity5 . @entity1 with @entity66 and BCR have highly similar transcriptional profiles, suggesting that measurement of PSA on its own is a poor surrogate for lethal disease. Use of genomic testing in @entity1 undergoing RP with an initial rise in PSA level may be useful to improve secondary therapy decision-making.
