Prognostic value of circulating tumor cells in patients with bladder cancer: A meta-analysis

Abstract

Background Circulating tumor cells (CTCs) have been considered diagnostic and prognostic biomarkers for urothelial cancer. However, the prognostic role of CTCs in bladder cancer (BC) remains controversial. Here, we conducted a meta-analysis to evaluate the prognostic significance of CTCs for patients with BC. Methods All studies relevant to this topic were searched in the PubMed, Embase, and Web of Science databases. The hazard ratio (HR) and 95% confidence interval (95% CI) were set as effect measures. The outcomes were overall survival (OS), cancer-free survival (CSS), progression-free survival (PFS)/time to progression (TTP), and disease-free survival (DFS)/recurrence-free survival (RFS)/time to first recurrence (TFR). All analyses were conducted in STATA 15.1. Results Eleven eligible studies comprising 1,062 patients with BC were included in this meta-analysis. Overall analyses showed that CTC-positive patients had poorer survival (OS: HR 3.88, 95% CI 2.52–5.96, p < 0.001; CSS: HR 3.89, 95% CI 2.15–7.04, p < 0.001) and more aggressive progression (PFS/TTP: HR 5.92, 95% CI 3.75–9.35, p < 0.001; DFS/RFS/TFR: HR 4.57, 95% CI 3.34–6.25, p < 0.001) than CTC-negative patients. Subgroup analyses according to the number of patients, detection method, positivity rate, and follow-up time revealed that the presence of CTCs predicted a high risk of mortality and disease progression in most subgroups. Conclusion The meta-analysis confirmed that CTCs are a promising prognostic biomarker of poor survival and aggressive tumor progression for patients with BC. Prospero registration number CRD42021224865.

Exploring the Clinical Utility of Pancreatic Cancer Circulating Tumor Cells

“…As with many other solid cancers [100][101][102][103], the detection and enumeration of CTCs has clinical utility as a prognostic marker in PDAC. Comprehensive reviews and metaanalyses of up to 19 studies comprising over 1300 PDAC patients have demonstrated that the detection of CTCs correlates with worse progression-free survival and overall survival [27,[104][105][106].…”

Correlation between High PD-L1 and EMT/Invasive Genes Expression and Reduced Recurrence-Free Survival in Blood-Circulating Tumor Cells from Patients with Non-Muscle-Invasive Bladder Cancer

“…CTCs are tumor cells that originate from a primary tumor, flowing through the bloodstream and circulating throughout the body, which may contribute to hematogenous metastasis [ 20 ]. Meta-analysis has shown that in MIBC patients CTCs are significantly associated with tumor progression and poor overall survival (OS) [ 21 ]. However, to date, blood CTCs have been understudied in NMIBC, although they are identified in these tumors.…”

Extracellular Vesicles and Circulating Tumour Cells - complementary liquid biopsies or standalone concepts?

“…Furthermore, at this juncture, we have a real field to maneuver, as many studies have indicated that both structures with high sensitivity and specificity can be used as a liquid biopsy in the diagnosis and prognosis of patients' outcomes and responses to treatment [36,44,91]. Nevertheless, many meta-analyses have confirmed the unique diagnostic and prognostic value of CTCs [92][93][94][95]. The same properties are attributed by meta-analyses to circulating EVs [96][97][98][99].…”