M J Sotelo1, J Sastre1, M L Maestro2, S Veganzones2, J M Viéitez3, V Alonso4, C Grávalos5, P Escudero6, R Vera7, E Aranda8, P García-Alfonso9, J Gallego-Plazas10, C Lopez11, C Pericay12, A Arrivi13, P Vicente14, P Ballesteros15, E Elez16, A López-Ladrón17, E Díaz-Rubio18. 1. Department of Medical Oncology. 2. Department of Clinical Analysis, Hospital Universitario Clínico San Carlos, Madrid. 3. Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo. 4. Department of Medical Oncology, Hospital Universitario Miguel Servet, Zaragoza. 5. Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid. 6. Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza. 7. Department of Medical Oncology, Complejo Hospitalario de Navarra, Pamplona. 8. Department of Medical Oncology, Hospital Reina Sofía, Universidad de Córdoba, Maimonides Institute of Biomedical Research (IMIBIC), Córdoba. 9. Department of Medical Oncology, Hospital Universitario Gregorio Marañón, Madrid. 10. Department of Medical Oncology, Hospital Universitario de Elche, Elche. 11. Department of Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander. 12. Department of Medical Oncology, Corporació Sanitària Universitària Parc Taulí, Sabadell. 13. Department of Medical Oncology, Hospital Son Llatzer, Palma de Mallorca. 14. Department of Medical Oncology, Hospital de Granollers, Granollers. 15. Department of Medical Oncology, Hospital Universitario Virgen de las Nieves, Granada. 16. Department of Medical Oncology, Hospital Vall d́Hebrón, Barcelona. 17. Department of Medical Oncology, Hospital Universitario de Valme, Sevilla, Spain. 18. Department of Medical Oncology edíazrubio.hcsc@salud.madrid.org.
Abstract
BACKGROUND: The prognostic role of circulating tumor cells (CTC) in early colorectal cancer (CRC) has not been determined yet. We evaluated the potential prognostic value of CTC in stage III CRC patients. PATIENTS AND METHODS: Prospective multicenter study of 519 patients with stage III CRC recruited between January 2009 and June 2010. CTC were enumerated with the CellSearch System after primary tumor resection and before the start of adjuvant therapy. A total of 472 patients were included in the analysis. RESULTS: CTC ≥1, ≥2, ≥3 and ≥5 were detected in 166 (35%), 93 (20%), 57 (12%) and 34 (7%) patients, respectively. Median follow-up was 40 months. In the overall population, CTC ≥1 (disease-free survival (DFS): HR 0.97, P = 0.85; overall survival (OS): HR 1.03, P = 0.89), ≥2 (DFS: HR 1.07, P = 0.76; OS: HR 1.02, P = 0.95), ≥3 (DFS: HR 0.96, P = 0.87; OS: HR 0.74, P = 0.41) and ≥5 (DFS: HR 0.72, P = 0.39; OS: HR 0.48, P = 0.21) were not associated with worse DFS and OS. No clinicopathological characteristics were significantly associated with the presence of CTC. In patients with disease relapse, the proportion with CTC ≥1 was not significantly different between those with single versus multiple metastatic locations (37.9% versus 31.4%, P = 0.761). In the multivariate analysis, CTC ≥1 was not an independent prognostic factor for DFS (HR 0.97, P = 0.87) and OS (HR 0.96, P = 0.89). CONCLUSION: CTC detection was not associated with worse DFS and OS in patients with stage III CRC. Given the scarcity of CTC in these patients, it is likely that CTC determined by CellSearch system does not have a prognostic role in this setting. However, a longer follow-up is needed.
BACKGROUND: The prognostic role of circulating tumor cells (CTC) in early colorectal cancer (CRC) has not been determined yet. We evaluated the potential prognostic value of CTC in stage III CRC patients. PATIENTS AND METHODS: Prospective multicenter study of 519 patients with stage III CRC recruited between January 2009 and June 2010. CTC were enumerated with the CellSearch System after primary tumor resection and before the start of adjuvant therapy. A total of 472 patients were included in the analysis. RESULTS: CTC ≥1, ≥2, ≥3 and ≥5 were detected in 166 (35%), 93 (20%), 57 (12%) and 34 (7%) patients, respectively. Median follow-up was 40 months. In the overall population, CTC ≥1 (disease-free survival (DFS): HR 0.97, P = 0.85; overall survival (OS): HR 1.03, P = 0.89), ≥2 (DFS: HR 1.07, P = 0.76; OS: HR 1.02, P = 0.95), ≥3 (DFS: HR 0.96, P = 0.87; OS: HR 0.74, P = 0.41) and ≥5 (DFS: HR 0.72, P = 0.39; OS: HR 0.48, P = 0.21) were not associated with worse DFS and OS. No clinicopathological characteristics were significantly associated with the presence of CTC. In patients with disease relapse, the proportion with CTC ≥1 was not significantly different between those with single versus multiple metastatic locations (37.9% versus 31.4%, P = 0.761). In the multivariate analysis, CTC ≥1 was not an independent prognostic factor for DFS (HR 0.97, P = 0.87) and OS (HR 0.96, P = 0.89). CONCLUSION: CTC detection was not associated with worse DFS and OS in patients with stage III CRC. Given the scarcity of CTC in these patients, it is likely that CTC determined by CellSearch system does not have a prognostic role in this setting. However, a longer follow-up is needed.