Prognostische Bedeutung des Tumorzellnachweises im Knochenmark im Vergleich zum Nodalstatus beim primären Mammakarzinom

Diel, IJ; Kaufmann, M.; Solomayer, Erich; Wallwiener, D.; Gollan, Ch.; Goerner, R.; Kaul, S.; Costa, Serban-Dan; Minckwitz, Gϋnter von; Holle, Rolf; Bastert, G.

doi:10.1055/s-2007-1023093

Cited by 10 publications

(3 citation statements)

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“…Numerous studies have shown that patients with positive tumor cell detection in the BM have a worse prognosis when compared to patients with a negative aspirate. Numerous single center studies ranging from 350 to over 800 patients with a median follow-up of up to 12 years have shown the prognostic significance of a Comparison of positivity rates between SD, PR, PD und CR: P = 0.32 b Comparison of positivity rates poor responder versus responder P = 0.11 c Comparision of positivity rates between CR and poor responders P = 0.07 d pathologic complete remission (pCR) e includes clinical complete remission with pathologic residual disease DTCs [20][21][22][23][24]. A recent pooled analysis including more than 4,700 patients confirmed these findings [14].…”

Section: Discussionmentioning

confidence: 99%

Primary systemic therapy does not eradicate disseminated tumor cells in breast cancer patients

Becker

Solomayer

Becker-Pergola

et al. 2007

Breast Cancer Res Treat

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Section: Discussionmentioning

confidence: 99%

Primary systemic therapy does not eradicate disseminated tumor cells in breast cancer patients

Becker

Solomayer

Becker-Pergola

et al. 2007

Breast Cancer Res Treat

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“…Thus, 4 samples determined to be positive by IMS-RT-PCR turned out to be negative when RT-PCR was used alone. Currently, immunocytochemistry is the routine method for diagnosing micrometastases (Diel et al 1992(Diel et al , 1997. In addition, we compared the results of these 26 samples by immunocytochemical staining using the cytospin technique with the mAb 5D3 against CK8,18,19.…”

Section: Discussionmentioning

confidence: 99%

Sensitive detection of micrometastases in bone marrow from patients with breast cancer using immunomagnetic isolation of tumor cells in combination with reverse transcriptase/polymerase chain reaction for cytokeratin-19

Zhong

Kaul

Lin

et al. 2000

Journal of Cancer Research and Clinical Oncology

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We report a highly sensitive method to detect rare human breast cancer cells, which combines an immunomagnetic separation (IMS) using antibody BM2 against MUC-1 with cytokeratin-19 (CK19) and the reverse transcriptase/polymerase chain reaction (RT-PCR). The IMS-RT-PCR technique allows the detection of 1 tumor cell/10(7)-10(8) mononuclear cells. This is at least ten times more sensitive than CK19 RT-PCR alone, or immunocytochemistry. All 117 peripheral blood and 8 bone marrow samples obtained from healthy donors as negative controls were positive for beta2-microglobulin by RT-PCR but negative for CK19 by IMS-RT-PCR or RT-PCR alone. Out of 26 bone marrow samples from breast cancer patients, 18 had CK19 transcripts detectable by IMS-RT-PCR. In contrast, only 14 and 13 samples from the 26 were found to be positive by RT-PCR alone or by routine immunocytochemical staining. In conclusion, IMS-RT-PCR for CK19 is a highly sensitive and specific method for detecting very low numbers of micrometastatic breast cancer cells in bone marrow amidst an excess of nonmalignant cells. For the early diagnosis of disseminating disease, this assay is more efficient than RT-PCR alone and routine immunocytochemistry.

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“…Die niedrige Proliferationsaktivität der disseminierten Tumorzellen könnte verantwortlich für die Persistenz nach adjuvanter Chemotherapie sein[36]. Allerdings wurde die klinische Bedeutung der Tumorzelldissemination sowohl mit Muzin-Antikörpern als auch mit Zytokeratin-Antikörpern gleicherweise nachgewiesen[26,31,32,34,35].Solomayer E-F et al Tumorzelldissemination unter neoadjuvanter ¼ Geburtsh Frauenheilk 2003; 63: 1267 ± 1273 Die Detektion disseminierter Tumorzellen liefert keine Information über deren metastatisches Potenzial. Hingegen konnten bei 90 % (18 von 20 Frauen) der Patientinnen ohne Tumorzelldissemination vor pCHT auch nach neoadjuvanter Therapie keine gestreuten Zellen nachgewiesen werden können.Im Gegensatz zur pCHT kommt es nach adjuvanter Chemotherapie zu einer Reduktion der Tumorzelldissemination.…”

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Tumorzelldissemination unter neoadjuvanter Chemotherapie bei Patientinnen mit primärem Mammakarzinom

2003

Geburtsh Frauenheilk

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ZusammenfassungFragestellung: Die präoperative Chemotherapie hat sich bei der Behandlung gröûerer Mammakarzinome etabliert. Der Einfluss der präoperativen Therapie auf die Tumorzelldissemination wurde bislang nicht untersucht. In dieser Studie wurde die Tumorzelldissemination vor und nach neoadjuvanter Chemotherapie evaluiert. Darüber hinaus wurde die prognostische Wertigkeit der Tumorzelldissemination nach neoadjuvanter Chemotherapie analysiert. Patientinnen und Methodik: 140 Patientinnen mit fortgeschrittenem Mammakarzinom (Tumorgröûe über 3 cm und ungünstiges Tumorgröûe-Brustvolumen-Verhältnis) erhielten eine neoadjuvante Chemotherapie (Epirubicin 90 mg/m 2 und Cyclophosphamid 600 mg/m 2 alle 3 Wochen, 3 bis 4 Zyklen). Bei allen Patientinnen wurde eine Knochenmarkaspiration nach der neoadjuvanten Chemotherapie durchgeführt. Bei 42 Patientinnen fand eine Knochenmarkaspiration sowohl vor als auch nach präoperativer Chemotherapie statt. Ergebnisse: Insgesamt wiesen 68 von 140 Patientinnen mit Mammakarzinom (49 %) nach Beendigung der neoadjuvanten Chemotherapie Tumorzellen im Knochenmark auf. Die Tumorzelldetektion errechnete sich als ein unabhängiger Prognosefaktor bezüglich des metastasenfreien Intervalls (p = 0,022; RR = 2,63) und des Gesamtüberlebens (p = 0,032; RR = 2,23). Bei 20 (von 42) Patientinnen konnten Tumorzellen im Knochenmark sowohl vor als auch nach der Chemotherapie nachgewiesen werden. 18 Patientinnen waren sowohl vor als auch nach Ende der Abstract Purpose: Neoadjuvant chemotherapy (pCHT) is an established method to reduce tumor size (downstaging) in breast cancer patients before performing breast conserving therapy. The consequences of pCHT on tumor cell dissemination (TCD) in these patients are not known. The aim of this study was to evaluate tumor cell dissemination before and after pCHT in breast cancer patients. In addition, the prognostic value of TCD after pCHT was studied. Patients and Methods: 140 women with non-inflammatory, locally advanced breast cancer (tumor size > 3 cm and an unfavorable relation between breast and tumor size) received neoadjuvant chemotherapy with Epirubicin/Cyclophosphamide (90/ 600 mg/m 2 every 3 weeks for 4 cycles). In all patients bilateral aspiration of bone marrow was performed at the time of surgery (after neoadjuvant chemotherapy). In 42 of the 140 patients additional bone marrow aspirations were taken before neoadjuvant chemotherapy. Results: 68 of 140 (49%) breast cancer patients had disseminated tumor cells (TCD) after neoadjuvant chemotherapy. TCD was an independent prognostic factor for disease free intervals (p = 0.022, RR = 2.63) and overall survival (p = 0.032, RR = 2.23). 20 of 42 patients had disseminated tumor cells before and after neoadjuvant chemotherapy. In contrast, 18 patients had no tumor cell dissemination during neoadjuvant treatment. Four patients had a change of their bone marrow status.

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Prognostische Bedeutung des Tumorzellnachweises im Knochenmark im Vergleich zum Nodalstatus beim primären Mammakarzinom

Cited by 10 publications

References 1 publication

Primary systemic therapy does not eradicate disseminated tumor cells in breast cancer patients

Primary systemic therapy does not eradicate disseminated tumor cells in breast cancer patients

Sensitive detection of micrometastases in bone marrow from patients with breast cancer using immunomagnetic isolation of tumor cells in combination with reverse transcriptase/polymerase chain reaction for cytokeratin-19

Tumorzelldissemination unter neoadjuvanter Chemotherapie bei Patientinnen mit primärem Mammakarzinom

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