Post-debulking circulating tumor cell as a poor prognostic marker in advanced stage ovarian cancer

Abstract

Circulating tumor cells (CTCs) have received enormous attention as a novel biomarker in various malignant diseases. We investigated the clinical association between the presence of perioperative CTCs and survival outcomes in women with ovarian cancer. In a total of 30 women who were scheduled to undergo a surgical treatment for ovarian cancer, peripheral blood samples were obtained before and after surgery. CTCs were isolated and counted using the optimized tapered-slit filter (TSF) platform. The association between the presence of perioperative CTCs and tumor features was evaluated. The impact of the presence of perioperative CTCs on progression-free survival (PFS) and overall survival (OS) rates were analyzed using a Kaplan–Meier method. The median age was 58 (range, 24–77) years, and the median follow-up period was 31.5 (range, 1–41) months. Overall, the CTC detection rate was not significantly different before and after surgery (76.7% vs 57.1%, P = .673). The presence of postoperative CTCs was not significantly associated with 3-year PFS (29.1% vs 58.3%, P = .130) and OS (84.4% vs 80.0%, P = .559) rates in the whole study population. In advanced stage, PFS rate in patients with postoperative CTCs had lower PFS rates than those without postoperative CTCs, although there was no statistical significance (18.8% vs 57.1%, P = .077). Postoperative CTC was more frequently detected in women who had lymph node involvement than those who did not (7/7 [100%] vs 3/10 [30.0%], P = .010). The presence of postoperative CTCs as detected using the TSF platform seems to be associated with poorer PFS rates in women with ovarian cancer of advanced stage. Further study with a larger population is warranted to validate our study findings.

Circulating Tumor Cells Enumerated by a Centrifugal Microfluidic Device as a Predictive Marker for Monitoring Ovarian Cancer Treatment: A Pilot Study

“…Pear et al reported that serial measurements using CAM+ selection of CTCs could predict therapeutic responsiveness in 31 patients with ovarian cancer who received standard paclitaxel plus carboplatin therapy [11]. Kim et al found that the positive detection of postoperative CTCs using the tapered-slit filter platform was associated with inferior PFS rates in 39 patients with stage III/IV ovarian cancer (18.8% vs. 57.1%, p = 0.077) [41]. We used size-based isolation first to achieve high throughput, label-free, high-yield CTCs isolation and then used the gold standard enumeration by immunostaining with EpCAM/CK+ to define CTCs.…”

Circulating tumor cells enumerated by a centrifugal microfluidic device as a predictive marker for treatment monitoring of ovarian cancer patients

“…Pear et al revealed that serial measurements using CAM + selection of CTCs could predict therapeutic responsiveness in 31 patients with ovarian cancer who received standard taxol plus carboplatin therapy [11]. Kim et al found that the positive detection of postoperative CTCs using the tapered-slit filter platform was associated with inferior PFS rates in 39 patients with stage III/IV ovarian cancer (18.8% vs. 57.1%, p = 0.077) [26].…”

Clinical Utility of Preoperative Assessment in Ovarian Cancer Cytoreduction

“…Liquid biopsy utilizes circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), circulating cell-free microRNAs, and circulating exosomes to diagnose and monitor cancer. CTCs are more commonly found in advanced stage (III and IV) than early stage ovarian cancer [ 89 ]. They are released from primary, metastatic or recurrent ovarian cancers and can be identified in the peripheral blood [ 90 ].…”