Molecular staging of genitourinary malignancies

The advances in molecular techniques useful for staging prostate cancer are a direct result of the availability of a well-defined prostate-specific molecular marker and the current emphasis on research pertaining to this disease. Once the genetic lesions associated with prostate cancer progression become more well defined, such molecular markers will add to the armamentarium available for developing molecular assays suitable for the diagnosis and early staging of this disease. Renal cell cancer has a similar potential for the development of molecular staging assays because of the likelihood of finding and characterizing renal cell-specific gene products that are also expressed by renal cell cancers. For bladder cancers, at this time it appears that the most suitable markers with which to develop molecular staging tests are those that define the genetic lesions associated with the development of the malignant characteristics or the progression of the early cancer cell to one having invasive potential. With the rapidly increasing experience of utilizing a molecular staging assay for prostate cancer, once these cell- and tumor-specific markers become more well defined, it should be a short process to create a suitable molecular staging test that will be of use for the other common GU tract tumors.