Recent advances in prostate cancer metastasis

Prostate cancer in men has now surpassed lung cancer as the most frequent non-cutaneous cancer. From a biological perspective, prostate carcinoma is unique among human malignancies in the wide discrepancy that exists between the prevalence of 'latent' cancer, recognizable only histologically, and that of the clinical disease. Histologically detected localized prostate cancers are heterogeneous, with only a small subset having undergone all of the malignant changes required to produce clinically aggressive tumors. Most of these 'latent' carcinoma never become fully malignant and do not threaten the life or well-being of the host. At present, it is not possible to predict which localized cancers will progress to clinically overt disease. Likewise, many patients have underevaluated and unpredictable extent of their prostate carcinoma, thus resulting in inadequate therapeutic strategies. It is clear that we need to identify molecular and/or cellular markers that are able to define the invasive and metastatic potential of prostate cancer on an individual patient basis. Acquisition of metastatic ability is a definitive criterion by which substage localized prostate cancers. Under the light of recent studies designed to identify some of the features associated with the metastatic phenotype of prostate cancer, the authors review recent advances aimed at gaining insight into those factors that may be involved in prostate cancer metastasis.