Comment on Han L et al.: Prognostic value of circulating tumor cells in patients with pancreatic cancer: a meta-analysis

Li, Chenggang; Zhao, Zhiming; Liu, Rong

doi:10.1007/s13277-014-2507-7

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…These results may deliver a trend if at all as covariates were not regarded. In addition, critical comments on study selection and statistical implementation advice caution though when interpreting this analysis (26).…”

Section: Discussionmentioning

confidence: 99%

Improved Risk Stratification by Circulating Tumor Cell Counts in Pancreatic Cancer

Effenberger

Schroeder

Hanssen

et al. 2018

Clinical Cancer Research

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Pancreatic cancer is one of the most devastating diseases with a 5-year survival rate of 3% to 5%. Here, we investigated whether circulating tumor cells (CTC) may predict metastatic spread and survival in pancreatic cancer patients. In a prospective study, we enrolled 69 pancreatic cancer patients. In peripheral blood, CTCs were identified by MACS enrichment (anti-cytokeratin/anti-EpCam) and subsequent automated analysis after combined anti-cytokeratin/anti-CD45/DAPI staining. CTC results were correlated to established clinicopathologic risk factors, detection of disseminated tumor cells (DTC) in bone marrow, and clinical outcome (follow-up time: 48 months). Median patient survival was 11 months (0-48 months). Thirty-eight patients were male and 31 were female, and the majority received gemcitabine (58/69). CTCs were present in 23 of 69 patients (33.3%) ranging from 1 to 19 cells (17 with >1 CTC). Although clinicopathologic parameters and DTC status did not correlate with CTC incidence, progression-free survival (PFS) and overall survival (OS) were significantly reduced in CTC-positive patients in univariate ( = 0.009, PFS; = 0.030, OS, both log rank) and multivariate analysis [HR = 4.543; confidence interval (CI), 1.549-13.329; = 0.006, PFS; HR = 2.093; CI, 1.081-4.050; = 0.028, OS, both Cox regression). Also within patients receiving chemotherapy, PFS was significantly reduced in CTC-positive patients in univariate ( = 0.013) and multivariate (HR = 4.203; CI, 1.416-12.471; = 0.010) analysis. CTCs affect the outcome of patients with pancreatic cancer independent from other risk factors, including patients receiving (adjuvant) cytotoxic therapy. CTC stratification may allow a better upfront identification of patients with a longer lifespan who might profit from new adjuvant therapies. .

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Section: Discussionmentioning

confidence: 99%

Improved Risk Stratification by Circulating Tumor Cell Counts in Pancreatic Cancer

Effenberger

Schroeder

Hanssen

et al. 2018

Clinical Cancer Research

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“…However, this study was unable to define the significance of CECs in patients with no known malignancy over the one year study period. The surgical patient population included in this study markedly differs from the patient populations of previous studies revealing potential prognostic significance of CTCs including fewer patients with metastatic disease (28, 30). Furthermore, our sub-group analysis of PDAC patients evaluated the rate of disease progression and survival, which are likely underestimates due to delay in reporting of deaths, lack of identification or testing for metastasis, or loss to follow-up.…”

Section: Discussionmentioning

confidence: 99%

Circulating Epithelial Cells in Patients with Pancreatic Lesions: Clinical and Pathologic Findings

Cauley

Pitman

Zhou

et al. 2015

Journal of the American College of Surgeons

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Background Circulating epithelial cell (CEC) isolation has provided diagnostic and prognostic information for a variety of cancers, previously supporting their identity as circulating tumor cells in the literature. However, we report CEC findings in patients with benign, pre-malignant, and malignant pancreatic lesions using a size-selective filtration device. Study Design Peripheral blood samples were drawn from patients found to have pancreatic lesions on preoperative imaging at a surgical clinic. Blood was filtered using ScreenCell® devices, which were evaluated microscopically by a pancreatic cytopathologist. Pathological data and clinical outcomes of these patients were obtained from medical records over a one year follow-up period. Results Nine healthy volunteers formed the control group and were found to be negative for CECs. There were 179 patients with pancreatic lesions that formed the study cohort. CECs were morphologically similar in patients with a variety of pancreatic lesions. Specifically, CECs were identified in 51 of 105 pancreatic ductal adenocarcinomas (PDAC) (49%), 7 of 11 neuroendocrine tumors (64%), 13 of 21 intraductal papillary mucinous neoplasms (62%), and 6 of 13 patients with chronic pancreatitis. Rates of CEC identification were similar in patients with benign, premalignant, and malignant lesions (p=0.41). In addition, CECs findings in PDAC patients were not associated with poor prognosis. Conclusions While CECs were not identified in healthy volunteers, they were identified in patients with benign, premalignant, and malignant pancreatic lesions. The presence of CECs in patients presenting with pancreatic lesions is not diagnostic of malignancy, nor is it prognostic for patients with PDAC.

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Monitoring disease progression and treatment efficacy with circulating tumor cells in esophageal squamous cell carcinoma: A case report

Qiao¹

2015

WJG

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This study investigated whether changes in circulating tumor cell (CTC) numbers reflect tumor progression and treatment efficacy in esophageal squamous cell carcinoma (ESCC). A 47-year-old male patient with ESCC is presented in this case study. The patient was evaluated for a series of serum tumor markers and subjected to radiological examinations before and after surgery and during follow-up over the course of five years. In addition, the CTCs in 7.5 mL of peripheral blood were enriched by magnetic-activated cell sorting negative selection and identified by immunofluorescence staining. Serum tumor markers remained within normal ranges and were discordant with imaging scans during the follow-up. Initially, one CTC was detected in the peripheral blood sample, and 14 were observed seven days after the operation. After 12 wk, subcutaneous metastases and bone metastases occurred, and the number of CTCs increased to 84. After 48 wk, lung metastases were noted, and the CTC level was 21. At 104 wk, the number of CTCs was 14, and disease recurrence was detected by positron emission tomography-computed tomography. The CTC counts were in accord with the imaging studies at several time points. The additional information provided by CTC enumeration could thus facilitate monitoring of disease status and treatment efficacy and provide support for treatment decisions.

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Comment on Han L et al.: Prognostic value of circulating tumor cells in patients with pancreatic cancer: a meta-analysis

Cited by 3 publications

References 9 publications

Improved Risk Stratification by Circulating Tumor Cell Counts in Pancreatic Cancer

Improved Risk Stratification by Circulating Tumor Cell Counts in Pancreatic Cancer

Circulating Epithelial Cells in Patients with Pancreatic Lesions: Clinical and Pathologic Findings

Monitoring disease progression and treatment efficacy with circulating tumor cells in esophageal squamous cell carcinoma: A case report

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