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Circulating tumor cells as an independent prognostic factor in advanced colorectal cancer: a retrospective study in 121 patients.
Int J Colorectal Dis. 2019 Apr; 34(4):589-597.IJ

Abstract

PURPOSE

This study aimed to evaluate the prognostic value of circulating tumor cells (CTCs) in advanced colorectal cancer (CRC) patients during chemotherapy course.

METHODS

From January 2016 to September 2017, the clinicopathological variables, such as gender, age, tumor location, tumor de-differentiation, depth of invasion, lymphatic invasion, distant metastasis, TNM stage, CTCs enumeration during 2-6 cycles of chemotherapy, and serum carcinoembryonic antigen (CEA) level during the same period, of 121 newly acquired and histopathologically confirmed CRC patients were collected from the Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine. All patients were followed up for survival until the end of November 2018. Statistical analysis focused on the associations between CTCs counts and clinicopathological variables. Overall survival (OS) and progression-free survival (PFS) among different prognostic factors were calculated using the Kaplan-Meier method, and the differences between the survival curves were compared by using the log-rank test. Factors of prognostic significance were investigated with the multivariate Cox regression analysis.

RESULTS

Here, 71 of 121 patients were CTC-positive, in which CTC-positive rate was positively correlated with the depth of invasion, lymphatic invasion, distant metastasis, TNM stage, and serum CEA level (P < 0.05 for all). However, no significant difference was found between CTC-positive and other clinicopathological variables (P > 0.05 for all), such as gender, age, tumor location, and tumor de-differentiation. CTCs counts gradually increased with the advancement of depth of invasion (P = 0.002), lymphatic invasion (P = 0.004), distant metastasis (P = 0.007), TNM stage (P = 0.001), serum CEA level (P = 0.001), and decreased tumor de-differentiation (P = 0.011). Furthermore, the Kaplan-Meier survival curves showed that patients with CTC-positive had a significantly unfavorable PFS (14 vs. 23 months, P = 0.001) and OS (18 vs. 25 months, P = 0.003). The multivariate Cox regression analyses revealed that the presence of CTCs during chemotherapy was an independent factor for unfavorable PFS (hazard ratio (HR) 2.682, P = 0.017, 95% confidence interval (CI) 1.193-6.029) and OS (HR 2.790, P = 0.048, 95% CI 1.010-7.705) in advanced CRC patients.

CONCLUSIONS

This study provided an evidence that the presence of CTCs may be valuable for predicting survival outcome, and CTCs was associated with unfavorable survival in advanced CRC patients during chemotherapy.

Authors+Show Affiliations

Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201999, China.Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201999, China.Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201999, China.Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201999, China.Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201999, China.Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201999, China.Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201999, China.Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201999, China.Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201999, China. Jiangbinwcr@163.com.Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201999, China. ayuan790415@126.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30627849

Citation

Wang, Lili, et al. "Circulating Tumor Cells as an Independent Prognostic Factor in Advanced Colorectal Cancer: a Retrospective Study in 121 Patients." International Journal of Colorectal Disease, vol. 34, no. 4, 2019, pp. 589-597.
Wang L, Zhou S, Zhang W, et al. Circulating tumor cells as an independent prognostic factor in advanced colorectal cancer: a retrospective study in 121 patients. Int J Colorectal Dis. 2019;34(4):589-597.
Wang, L., Zhou, S., Zhang, W., Wang, J., Wang, M., Hu, X., Liu, F., Zhang, Y., Jiang, B., & Yuan, H. (2019). Circulating tumor cells as an independent prognostic factor in advanced colorectal cancer: a retrospective study in 121 patients. International Journal of Colorectal Disease, 34(4), 589-597. https://doi.org/10.1007/s00384-018-03223-9
Wang L, et al. Circulating Tumor Cells as an Independent Prognostic Factor in Advanced Colorectal Cancer: a Retrospective Study in 121 Patients. Int J Colorectal Dis. 2019;34(4):589-597. PubMed PMID: 30627849.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Circulating tumor cells as an independent prognostic factor in advanced colorectal cancer: a retrospective study in 121 patients. AU - Wang,Lili, AU - Zhou,Shichao, AU - Zhang,Wenying, AU - Wang,Jiongyi, AU - Wang,Meiling, AU - Hu,Xiaohua, AU - Liu,Feng, AU - Zhang,Yanjie, AU - Jiang,Bin, AU - Yuan,Haihua, Y1 - 2019/01/10/ PY - 2018/12/14/accepted PY - 2019/1/11/pubmed PY - 2019/8/8/medline PY - 2019/1/11/entrez KW - Chemotherapy KW - Circulating tumor cells KW - Colorectal cancer KW - Predictive value KW - Survival SP - 589 EP - 597 JF - International journal of colorectal disease JO - Int J Colorectal Dis VL - 34 IS - 4 N2 - PURPOSE: This study aimed to evaluate the prognostic value of circulating tumor cells (CTCs) in advanced colorectal cancer (CRC) patients during chemotherapy course. METHODS: From January 2016 to September 2017, the clinicopathological variables, such as gender, age, tumor location, tumor de-differentiation, depth of invasion, lymphatic invasion, distant metastasis, TNM stage, CTCs enumeration during 2-6 cycles of chemotherapy, and serum carcinoembryonic antigen (CEA) level during the same period, of 121 newly acquired and histopathologically confirmed CRC patients were collected from the Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine. All patients were followed up for survival until the end of November 2018. Statistical analysis focused on the associations between CTCs counts and clinicopathological variables. Overall survival (OS) and progression-free survival (PFS) among different prognostic factors were calculated using the Kaplan-Meier method, and the differences between the survival curves were compared by using the log-rank test. Factors of prognostic significance were investigated with the multivariate Cox regression analysis. RESULTS: Here, 71 of 121 patients were CTC-positive, in which CTC-positive rate was positively correlated with the depth of invasion, lymphatic invasion, distant metastasis, TNM stage, and serum CEA level (P < 0.05 for all). However, no significant difference was found between CTC-positive and other clinicopathological variables (P > 0.05 for all), such as gender, age, tumor location, and tumor de-differentiation. CTCs counts gradually increased with the advancement of depth of invasion (P = 0.002), lymphatic invasion (P = 0.004), distant metastasis (P = 0.007), TNM stage (P = 0.001), serum CEA level (P = 0.001), and decreased tumor de-differentiation (P = 0.011). Furthermore, the Kaplan-Meier survival curves showed that patients with CTC-positive had a significantly unfavorable PFS (14 vs. 23 months, P = 0.001) and OS (18 vs. 25 months, P = 0.003). The multivariate Cox regression analyses revealed that the presence of CTCs during chemotherapy was an independent factor for unfavorable PFS (hazard ratio (HR) 2.682, P = 0.017, 95% confidence interval (CI) 1.193-6.029) and OS (HR 2.790, P = 0.048, 95% CI 1.010-7.705) in advanced CRC patients. CONCLUSIONS: This study provided an evidence that the presence of CTCs may be valuable for predicting survival outcome, and CTCs was associated with unfavorable survival in advanced CRC patients during chemotherapy. SN - 1432-1262 UR - https://www.unboundmedicine.com/medline/citation/30627849/Circulating_tumor_cells_as_an_independent_prognostic_factor_in_advanced_colorectal_cancer:_a_retrospective_study_in_121_patients_ L2 - https://doi.org/10.1007/s00384-018-03223-9 DB - PRIME DP - Unbound Medicine ER -