Biomarkers and mechanisms associated with recurrent prostate cancer.

Prostate cancer is one of the leading causes of cancer death among men in the United States. Although, recent advancement in diagnostic tools has significantly increased early detection and decreased cases of advanced diseases, high numbers of patients who underwent treatment still experience recurrent disease at distant sites, after long periods of remission. Therefore, it is of paramount importance to elucidate the pathological mechanism of the tumor recurrence in order to identify better therapeutic targets and also to distinguish patients with indolent disease from patients with recurrent disease at the time of surgery for optimization of therapeutic intervention. Recurrent tumor cells disseminate at a very early stage even before diagnosis of localized disease and remain dormant as "residual disease" in patients for a long period of time. Colonization and recurrent growth at distant site requires acquisition of genetic and epigenetic alterations and remodeling of signaling pathways. This review focuses on recent advances on identification of biomarkers associated with early and late recurrent disease as well as mechanisms involved during recurrence of prostate cancer.