Prognostic value of preoperative circulating tumor cells counts in patients with UICC stage I-IV colorectal cancer

PLoS One. 2021 Jun 10;16(6):e0252897. doi: 10.1371/journal.pone.0252897. eCollection 2021.

Abstract

Colorectal cancer (CRC) is one of the leading causes of cancer death worldwide. There is an urgent need to identify prognostic markers for patients undergoing curative resection of CRC. The detection of circulating tumor cells in peripheral blood is a promising approach to identify high-risk patients with disseminated disease in colorectal cancer. This study aims to evaluate the prognostic relevance of preoperative CTCs using the Cellsearch® system (CS) in patients, who underwent resection with curative intent of different stages (UICC I-IV) of colorectal cancer. Out of 91 Patients who underwent colorectal resection, 68 patients were included in this study. CTC analysis was performed in patients with CRC UICC stages I-IV immediately before surgery. Data were correlated with clinicopathological parameters and patient outcomes. One or more CTCs/7.5 mL were detected in 45.6% (31/68) of patients. CTCs were detected in all stages of the Union of International Cancer Control (UICC), in stage I (1/4, 25%), in stage II (4/12, 33.3%), in stage III (5/19, 26.3%) and in stage IV (21/33, 63.6%). The detection of ≥ 1 CTCs/ 7.5ml correlated to the presence of distant overt metastases (p = 0.014) as well as with shorter progression-free (p = 0.008) and overall survival (p = 0.008). Multivariate analyses showed that the detection of ≥ 1 CTCs/ 7.5ml is an independent prognostic indicator for overall survival (HR, 3.14; 95% CI, 1.18-8.32; p = 0.021). The detection of CTCs is an independent and strong prognostic factor in CRC, which might improve the identification of high-risk patients in future clinical trials.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / blood*
  • Cell Count
  • Colorectal Neoplasms / pathology*
  • Colorectal Neoplasms / surgery
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Neoplastic Cells, Circulating / pathology*
  • Prognosis
  • Prospective Studies
  • Survival Analysis
  • Young Adult

Substances

  • Biomarkers, Tumor

Grants and funding

The author(s) received no specific funding for this work.