Detection of Circulating Tumor Cells in Locally Advanced High-risk Prostate Cancer During Neoadjuvant Chemotherapy and Radical Prostatectomy

Aim: Circulating tumour cells (CTCs) may be prognostic for biochemical recurrence-free survival (bRFS) in patients with locally advanced high-risk prostate cancer (LAPC) undergoing neoadjuvant chemohormonal therapy (NCHT) and radical prostatectomy (RP).

Patients And Methods: CTCs were detected before and after NCHT, after RP and at follow-up using the CellSearch™-System for 59 blood samples (20 ml) from patients with LAPC (n=15) and, additionally, for 15 control samples.

Results: The median 5-year progression risk was 90%. CTCs (≥1/20 ml) were detected in 53.3% of patients, with a detection rate of 18.6% in sample-adjusted analysis. CTCs were detected at baseline in 20% of patients with LAPC and 6.7% of controls (p=0.6). CTC findings displayed no association with clinicopathological characteristics. The median bRFS of CTC-negative vs. CTC-positive patients was 43.7 (95% confidence interval not reached) vs. 29.2 months (95% confidence interval=26.8-60.6 months), without statistical significance (p=0.76).

Conclusion: During NCHT and RP, longitudinal CTC presence seems to some extent stochastic, although patients with persistant CTCs post-RP developed biochemical recurrence. No significant association with clinicopathological characteristics or bRFS was observed in patients with LAPC, despite a trend for reduced bRFS in patients with detectable CTCs.