Detection of circulating tumor cells in patients with locally advanced rectal cancer undergoing neoadjuvant therapy followed by curative surgery

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Abstract

Purpose: Circulating tumor cells (CTCs) represent an independent prognostic factor in metastatic colorectal cancer, while their significance in early stages is still an open issue. The aim of the study is to investigate the role of CTCs in rectal cancer patients undergoing neoadjuvant chemoradiotherapy (CT-RT). Methods: In this prospective single institutional study, cT3-4 and/or N+ rectal cancer was treated with neoadjuvant CT-RT. The primary endpoints were as follows: evaluation of CTCs at baseline (t0), after CT-RT (t1), within 7 days after surgery (t2), and at 6 months from surgery (t3) and correlation with main patient/tumor characteristics, CEA, response to neoadjuvant therapy, and disease-free survival (DFS). CTCs were enumerated with the CellSearch System in 22.5 ml peripheral blood. A repeated measure analysis for binary outcome was used to evaluate over time changes in the percentage of CTCs detectable in blood samples. Results: Of the 90 patients enrolled in this study, 85 were eligible consisting of 52 males and 33 females. Median age was 63 years and median follow-up was 38 months. CTCs were available for all patients at t0, for 67 at t1, for 68 at t2, and for 62 at t3. CTCs >0 were reported on 16 (19 %) at t0, on 5 (7.5 %) at t1, on 6 (9 %) at t2, and on 3 (5 %) at t3 (P value for trend 0.039). Only for CT-RT responders, CTCs reduced from t0 to t1. No statistically significant association was found between CTCs and main patient/tumor characteristics and DFS. Conclusions: Sixteen patients (19 %) had CTCs ≥1 at t0 with reduction in CTC number in case of objective remissions. The proportion of patients with CTCs ≥1 decreased over the time as the therapeutic course proceeded. Much effort should be oriented toward increasing CTC detection rate by enhancing technical tests and achieving better patient characterization.

Original languageEnglish
Pages (from-to)1053-1059
Number of pages7
JournalInternational Journal of Colorectal Disease
Volume29
Issue number9
DOIs
Publication statusPublished - 2014

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Circulating Neoplastic Cells
Neoadjuvant Therapy
Rectal Neoplasms
Disease-Free Survival
Chemoradiotherapy
Ambulatory Surgical Procedures

Keywords

  • Circulating tumor cells
  • Locally advanced rectal cancer
  • Neoadjuvant chemoradiotherapy
  • Prognostic factors

ASJC Scopus subject areas

  • Gastroenterology
  • Medicine(all)

Cite this

@article{4c97d8b408e24601af1f9022872a8efc,
title = "Detection of circulating tumor cells in patients with locally advanced rectal cancer undergoing neoadjuvant therapy followed by curative surgery",
abstract = "Purpose: Circulating tumor cells (CTCs) represent an independent prognostic factor in metastatic colorectal cancer, while their significance in early stages is still an open issue. The aim of the study is to investigate the role of CTCs in rectal cancer patients undergoing neoadjuvant chemoradiotherapy (CT-RT). Methods: In this prospective single institutional study, cT3-4 and/or N+ rectal cancer was treated with neoadjuvant CT-RT. The primary endpoints were as follows: evaluation of CTCs at baseline (t0), after CT-RT (t1), within 7 days after surgery (t2), and at 6 months from surgery (t3) and correlation with main patient/tumor characteristics, CEA, response to neoadjuvant therapy, and disease-free survival (DFS). CTCs were enumerated with the CellSearch System in 22.5 ml peripheral blood. A repeated measure analysis for binary outcome was used to evaluate over time changes in the percentage of CTCs detectable in blood samples. Results: Of the 90 patients enrolled in this study, 85 were eligible consisting of 52 males and 33 females. Median age was 63 years and median follow-up was 38 months. CTCs were available for all patients at t0, for 67 at t1, for 68 at t2, and for 62 at t3. CTCs >0 were reported on 16 (19 {\%}) at t0, on 5 (7.5 {\%}) at t1, on 6 (9 {\%}) at t2, and on 3 (5 {\%}) at t3 (P value for trend 0.039). Only for CT-RT responders, CTCs reduced from t0 to t1. No statistically significant association was found between CTCs and main patient/tumor characteristics and DFS. Conclusions: Sixteen patients (19 {\%}) had CTCs ≥1 at t0 with reduction in CTC number in case of objective remissions. The proportion of patients with CTCs ≥1 decreased over the time as the therapeutic course proceeded. Much effort should be oriented toward increasing CTC detection rate by enhancing technical tests and achieving better patient characterization.",
keywords = "Circulating tumor cells, Locally advanced rectal cancer, Neoadjuvant chemoradiotherapy, Prognostic factors",
author = "Elena Magni and Edoardo Botteri and Ravenda, {Paola S.} and Cassatella, {Maria C.} and Emilio Bertani and Antonio Chiappa and Fabrizio Luca and Laura Zorzino and Bianchi, {Paolo Pietro} and Laura Adamoli and Sandri, {Maria T.} and Zampino, {Maria G.}",
year = "2014",
doi = "10.1007/s00384-014-1958-z",
language = "English",
volume = "29",
pages = "1053--1059",
journal = "International Journal of Colorectal Disease",
issn = "0179-1958",
publisher = "Springer Verlag",
number = "9",

}

TY - JOUR

T1 - Detection of circulating tumor cells in patients with locally advanced rectal cancer undergoing neoadjuvant therapy followed by curative surgery

AU - Magni, Elena

AU - Botteri, Edoardo

AU - Ravenda, Paola S.

AU - Cassatella, Maria C.

AU - Bertani, Emilio

AU - Chiappa, Antonio

AU - Luca, Fabrizio

AU - Zorzino, Laura

AU - Bianchi, Paolo Pietro

AU - Adamoli, Laura

AU - Sandri, Maria T.

AU - Zampino, Maria G.

PY - 2014

Y1 - 2014

N2 - Purpose: Circulating tumor cells (CTCs) represent an independent prognostic factor in metastatic colorectal cancer, while their significance in early stages is still an open issue. The aim of the study is to investigate the role of CTCs in rectal cancer patients undergoing neoadjuvant chemoradiotherapy (CT-RT). Methods: In this prospective single institutional study, cT3-4 and/or N+ rectal cancer was treated with neoadjuvant CT-RT. The primary endpoints were as follows: evaluation of CTCs at baseline (t0), after CT-RT (t1), within 7 days after surgery (t2), and at 6 months from surgery (t3) and correlation with main patient/tumor characteristics, CEA, response to neoadjuvant therapy, and disease-free survival (DFS). CTCs were enumerated with the CellSearch System in 22.5 ml peripheral blood. A repeated measure analysis for binary outcome was used to evaluate over time changes in the percentage of CTCs detectable in blood samples. Results: Of the 90 patients enrolled in this study, 85 were eligible consisting of 52 males and 33 females. Median age was 63 years and median follow-up was 38 months. CTCs were available for all patients at t0, for 67 at t1, for 68 at t2, and for 62 at t3. CTCs >0 were reported on 16 (19 %) at t0, on 5 (7.5 %) at t1, on 6 (9 %) at t2, and on 3 (5 %) at t3 (P value for trend 0.039). Only for CT-RT responders, CTCs reduced from t0 to t1. No statistically significant association was found between CTCs and main patient/tumor characteristics and DFS. Conclusions: Sixteen patients (19 %) had CTCs ≥1 at t0 with reduction in CTC number in case of objective remissions. The proportion of patients with CTCs ≥1 decreased over the time as the therapeutic course proceeded. Much effort should be oriented toward increasing CTC detection rate by enhancing technical tests and achieving better patient characterization.

AB - Purpose: Circulating tumor cells (CTCs) represent an independent prognostic factor in metastatic colorectal cancer, while their significance in early stages is still an open issue. The aim of the study is to investigate the role of CTCs in rectal cancer patients undergoing neoadjuvant chemoradiotherapy (CT-RT). Methods: In this prospective single institutional study, cT3-4 and/or N+ rectal cancer was treated with neoadjuvant CT-RT. The primary endpoints were as follows: evaluation of CTCs at baseline (t0), after CT-RT (t1), within 7 days after surgery (t2), and at 6 months from surgery (t3) and correlation with main patient/tumor characteristics, CEA, response to neoadjuvant therapy, and disease-free survival (DFS). CTCs were enumerated with the CellSearch System in 22.5 ml peripheral blood. A repeated measure analysis for binary outcome was used to evaluate over time changes in the percentage of CTCs detectable in blood samples. Results: Of the 90 patients enrolled in this study, 85 were eligible consisting of 52 males and 33 females. Median age was 63 years and median follow-up was 38 months. CTCs were available for all patients at t0, for 67 at t1, for 68 at t2, and for 62 at t3. CTCs >0 were reported on 16 (19 %) at t0, on 5 (7.5 %) at t1, on 6 (9 %) at t2, and on 3 (5 %) at t3 (P value for trend 0.039). Only for CT-RT responders, CTCs reduced from t0 to t1. No statistically significant association was found between CTCs and main patient/tumor characteristics and DFS. Conclusions: Sixteen patients (19 %) had CTCs ≥1 at t0 with reduction in CTC number in case of objective remissions. The proportion of patients with CTCs ≥1 decreased over the time as the therapeutic course proceeded. Much effort should be oriented toward increasing CTC detection rate by enhancing technical tests and achieving better patient characterization.

KW - Circulating tumor cells

KW - Locally advanced rectal cancer

KW - Neoadjuvant chemoradiotherapy

KW - Prognostic factors

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U2 - 10.1007/s00384-014-1958-z

DO - 10.1007/s00384-014-1958-z

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JO - International Journal of Colorectal Disease

JF - International Journal of Colorectal Disease

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