The prognostic value of circulating tumor cells in patients with melanoma: A systematic review and meta-analysis

Simone Mocellin, Dave Hoon, Alessandro Ambrosi, Donato Nitti, Carlo Riccardo Rossi

Research output: Contribution to journalArticlepeer-review


Background: The detection of circulating tumor cells (CTC) in patients with melanoma represents an appealing prognostic tool, but no consensus exists on this topic. We aimed to comprehensively and quantitatively summarize the evidence for the use of CTC to predict patients' clinical outcome. Methods: Fifty-three studies enrolling 5,433 patients were reviewed. Correlation of CTC status with tumor-node-metastasis disease stage and patients' overall (OS) and progression-free (PFS) survival was assessed by means of association statistics and meta-analysis, respectively. Results: CTC status correlated with both tumor-node-metastasis stage (stage I, 32%; stage II, 41.7%; stage III, 41.1%; stage IV, 47.4%; Ptrend <0.0001) and survival (OS: hazard ratio, 2.42; 95% confidence interval, 1.7-3.45, P <0.0001; PFS: hazard ratio, 2.45; 95% confidence interval, 1.78-3.38; P <0.0001). However, statistical heterogeneity was significant for both OS and PFS, likely underscoring the wide variability in study design. Furthermore, CTC positivity rates in early stages were higher and in the metastatic setting were lower than expected, which indicates an unsatisfactory accuracy of currently available CTC detection assays. Conclusions: Our findings suggest that CTC might have a clinically valuable prognostic power in patients with melanoma. However, the heterogeneity of the studies thus far published warrants caution not to overestimate the favorable results of pooled data.

Original languageEnglish
Pages (from-to)4605-4613
Number of pages9
JournalClinical Cancer Research
Issue number15
Publication statusPublished - Aug 1 2006

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


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