Postoperative Detection of Circulating Tumor Cells Predicts Tumor Recurrence in Colorectal Cancer Patients

Overview

Journal J Gastrointest Surg

Specialty Gastroenterology

Date 2013 Jul 2

PMID 23813048

Citations 29

Authors

Gennaro Galizia

Marica Gemei

Michele Orditura

Ciro Romano

Anna Zamboli

Paolo Castellano

Andrea Mabilia

Annamaria Auricchio

Ferdinando De Vita

Luigi Del Vecchio

Eva Lieto

Affiliations

Soon will be listed here.

Abstract

Introduction: Circulating tumor cells are thought to play a crucial role in the development of distant metastases. Their detection in the blood of colorectal cancer patients may be linked to poor outcome, but current evidence is controversial.

Materials And Methods: Pre- and postoperative flow cytometric analysis of blood samples was carried out in 76 colorectal cancer patients undergoing surgical resection. The EpCAM/CD326 epithelial surface antigen was used to identify circulating tumor cells.

Results: Fifty-four (71%) patients showed circulating tumor cells preoperatively, and all metastatic patients showed high levels of circulating tumor cells. Surgical resection resulted in a significant decrease in the levels of circulating tumor cells. Among 69 patients undergoing radical surgery, 16 had high postoperative levels of circulating tumor cells, and 12 (75%) experienced tumor recurrence. High postoperative level of circulating tumor cells was the only independent variable related to cancer relapse. In patients without circulating tumor cells, the progression-free survival rate increased from 16 to 86%, with a reduction in the risk of tumor relapse greater than 90%.

Conclusions: High postoperative levels of circulating tumor cells accurately predicted tumor recurrence, suggesting that assessment of circulating tumor cells could optimize tailored management of colorectal cancer patients.

Citing Articles

A randomized trial of aerobic exercise in colorectal cancer: Rationale, design, recruitment, and exercise adherence results.

Compton S, Yang S, Maniscalco L, Muhsen R, Shrestha P, Wu X Contemp Clin Trials. 2024; 146():107702.

PMID: 39362405 PMC: 11531371. DOI: 10.1016/j.cct.2024.107702.

Could Flow Cytometry Provide New Prognostic Markers in Colorectal Cancer?.

Georvasili V, Markopoulos G, Lampri E, Lianos G, Vartholomatos G, Mitsis M J Clin Med. 2024; 13(16).

PMID: 39200895 PMC: 11355755. DOI: 10.3390/jcm13164753.

Changes of circulating tumor cells expressing CD90 and EpCAM in early-phase of atezolizumab and bevacizumab for hepatocellular carcinoma.

Nosaka T, Murata Y, Akazawa Y, Takahashi K, Naito T, Matsuda H Heliyon. 2024; 10(14):e34441.

PMID: 39108869 PMC: 11301359. DOI: 10.1016/j.heliyon.2024.e34441.

OLFM2 promotes epithelial-mesenchymal transition, migration, and invasion in colorectal cancer through the TGF-β/Smad signaling pathway.

Tang Y, Liu Y, Wang X, Guo H, Chen L, Hu G BMC Cancer. 2024; 24(1):204.

PMID: 38350902 PMC: 10865519. DOI: 10.1186/s12885-024-11925-3.

Circulating Tumour Cell Associated MicroRNA Profiles Change during Chemoradiation and Are Predictive of Response in Locally Advanced Rectal Cancer.

Lim S, Chua W, Ng W, Ip E, Marques T, Tran N Cancers (Basel). 2023; 15(16).

PMID: 37627212 PMC: 10452825. DOI: 10.3390/cancers15164184.

References

Cohen S, Punt C, Iannotti N, Saidman B, Sabbath K, Gabrail N . Prognostic significance of circulating tumor cells in patients with metastatic colorectal cancer. Ann Oncol. 2009; 20(7):1223-9. DOI: 10.1093/annonc/mdn786. View

Pelkey T, Frierson Jr H, Bruns D . Molecular and immunological detection of circulating tumor cells and micrometastases from solid tumors. Clin Chem. 1996; 42(9):1369-81. View

Dalerba P, Dylla S, Park I, Liu R, Wang X, Cho R . Phenotypic characterization of human colorectal cancer stem cells. Proc Natl Acad Sci U S A. 2007; 104(24):10158-63. PMC: 1891215. DOI: 10.1073/pnas.0703478104. View

van der Gun B, Melchers L, Ruiters M, de Leij L, McLaughlin P, Rots M . EpCAM in carcinogenesis: the good, the bad or the ugly. Carcinogenesis. 2010; 31(11):1913-21. DOI: 10.1093/carcin/bgq187. View

Allard W, Matera J, Miller M, Repollet M, Connelly M, Rao C . Tumor cells circulate in the peripheral blood of all major carcinomas but not in healthy subjects or patients with nonmalignant diseases. Clin Cancer Res. 2004; 10(20):6897-904. DOI: 10.1158/1078-0432.CCR-04-0378. View

Chapuis P, Dent O, Bokey E, Newland R, Sinclair G . Adverse histopathological findings as a guide to patient management after curative resection of node-positive colonic cancer. Br J Surg. 2004; 91(3):349-54. DOI: 10.1002/bjs.4389. View

Zlobec I . Novel biomarkers for the prediction of metastasis in colorectal cancer. Expert Opin Med Diagn. 2013; 7(2):137-46. DOI: 10.1517/17530059.2013.753054. View

Khan M, Kirkwood A, Tsigani T, Garcia-Hernandez J, Hartley J, Caplin M . Circulating tumor cells as prognostic markers in neuroendocrine tumors. J Clin Oncol. 2012; 31(3):365-72. DOI: 10.1200/JCO.2012.44.2905. View

Sun Y, Yang X, Zhou J, Qiu S, Fan J, Xu Y . Circulating tumor cells: advances in detection methods, biological issues, and clinical relevance. J Cancer Res Clin Oncol. 2011; 137(8):1151-73. DOI: 10.1007/s00432-011-0988-y. View

10.

Koch M, Kienle P, Kastrati D, Antolovic D, Schmidt J, Herfarth C . Prognostic impact of hematogenous tumor cell dissemination in patients with stage II colorectal cancer. Int J Cancer. 2006; 118(12):3072-7. DOI: 10.1002/ijc.21784. View

11.

Lu C, Tsai H, Uen Y, Hu H, Chen C, Cheng T . Circulating tumor cells as a surrogate marker for determining clinical outcome to mFOLFOX chemotherapy in patients with stage III colon cancer. Br J Cancer. 2013; 108(4):791-7. PMC: 3590657. DOI: 10.1038/bjc.2012.595. View

12.

Altman D, Vergouwe Y, Royston P, Moons K . Prognosis and prognostic research: validating a prognostic model. BMJ. 2009; 338:b605. DOI: 10.1136/bmj.b605. View

13.

de Haas R, Wicherts D, Andreani P, Pascal G, Saliba F, Ichai P . Impact of expanding criteria for resectability of colorectal metastases on short- and long-term outcomes after hepatic resection. Ann Surg. 2011; 253(6):1069-79. DOI: 10.1097/SLA.0b013e318217e898. View

14.

Armstrong A, Marengo M, Oltean S, Kemeny G, Bitting R, Turnbull J . Circulating tumor cells from patients with advanced prostate and breast cancer display both epithelial and mesenchymal markers. Mol Cancer Res. 2011; 9(8):997-1007. PMC: 3157566. DOI: 10.1158/1541-7786.MCR-10-0490. View

15.

Sidhu R, Rong A, Dahlberg S . Evaluation of progression-free survival as a surrogate endpoint for survival in chemotherapy and targeted agent metastatic colorectal cancer trials. Clin Cancer Res. 2013; 19(5):969-76. DOI: 10.1158/1078-0432.CCR-12-2502. View

16.

Patkar N, Alex A, B B, Ahmed R, Abraham A, George B . Standardizing minimal residual disease by flow cytometry for precursor B lineage acute lymphoblastic leukemia in a developing country. Cytometry B Clin Cytom. 2012; 82(4):252-8. DOI: 10.1002/cyto.b.21017. View

17.

Ricci-Vitiani L, Lombardi D, Pilozzi E, Biffoni M, Todaro M, Peschle C . Identification and expansion of human colon-cancer-initiating cells. Nature. 2006; 445(7123):111-5. DOI: 10.1038/nature05384. View

18.

Yokobori T, Iinuma H, Shimamura T, Imoto S, Sugimachi K, Ishii H . Plastin3 is a novel marker for circulating tumor cells undergoing the epithelial-mesenchymal transition and is associated with colorectal cancer prognosis. Cancer Res. 2013; 73(7):2059-69. DOI: 10.1158/0008-5472.CAN-12-0326. View

19.

Chiappini F . Circulating tumor cells measurements in hepatocellular carcinoma. Int J Hepatol. 2012; 2012:684802. PMC: 3368319. DOI: 10.1155/2012/684802. View

20.

ENGELL H . Cancer cells in the circulating blood; a clinical study on the occurrence of cancer cells in the peripheral blood and in venous blood draining the tumour area at operation. Acta Chir Scand Suppl. 1955; 201:1-70. View