Baseline CTC Count as a Predictor of Long-Term Outcomes in High-Risk Prostate Cancer

Wojciech A Cieślikowski; Piotr Milecki; Monika Świerczewska; Agnieszka Ida; Michał Kasperczak; Agnieszka Jankowiak; Michał Nowicki; Klaus Pantel; Catherine Alix-Panabières; Maciej Zabel; Andrzej Antczak; Joanna Budna-Tukan

doi:10.3390/jpm13040608

Baseline CTC Count as a Predictor of Long-Term Outcomes in High-Risk Prostate Cancer

J Pers Med. 2023 Mar 30;13(4):608. doi: 10.3390/jpm13040608.

Affiliations

¹ Department of Urology, Poznan University of Medical Sciences, 62-385 Poznan, Poland.
² Department of Electroradiology, Poznan University of Medical Sciences, 61-868 Poznan, Poland.
³ Department of Histology and Embryology, Poznan University of Medical Sciences, 60-781 Poznan, Poland.
⁴ Department of Tumor Biology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany.
⁵ Laboratory of Rare Human Circulating Cells, University Medical Center, 34093 Montpellier, France.
⁶ Division of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, 50-368 Wroclaw, Poland.
⁷ Division of Anatomy and Histology, University of Zielona Góra, 65-046 Zielona Góra, Poland.

Abstract

The aim of the present study was to verify whether the baseline circulating tumor cell (CTC) count might serve as a predictor of overall survival (OS) and metastasis-free survival (MFS) in patients with high-risk prostate cancer (PCa) during a follow-up period of at least 5 years. CTCs were enumerated using three different assay formats in 104 patients: the CellSearch^® system, EPISPOT assay and GILUPI CellCollector. A total of 57 (55%) patients survived until the end of the follow-up period, with a 5 year OS of 66% (95% CI: 56-74%). The analysis of univariate Cox proportional hazard models identified a baseline CTC count ≥ 1, which was determined with the CellSearch^® system, a Gleason sum ≥ 8, cT ≥ 2c and metastases at initial diagnosis as significant predictors of a worse OS in the entire cohort. The CTC count ≥ 1 was also the only significant predictor of a worse OS in a subset of 85 patients who presented with localized PCa at the baseline. The baseline CTC number did not affect the MFS. In conclusion, the baseline CTC count can be considered a determinant of survival in high-risk PCa and also in patients with a localized disease. However, determining the prognostic value of the CTC count in patients with localized PCa would optimally require longitudinal monitoring of this parameter.

Keywords: circulating tumor cells; metastasis-free survival; overall survival; prognosis; prostate cancer.

Grants and funding

The study was supported from ERA-NET-TRANSCAN/03/2013 (acronym CTC-SCAN) and ERA-NET-TRANSCAN/01/2018 (acronym PROLIPSY) grants from the National Center for Research and Development (Poland).