All circulating EpCAM+CK+CD45- objects predict overall survival in castration-resistant prostate cancer

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: Presence of five or more circulating tumor cells (CTC) in patients with metastatic carcinomas is associated with poor survival. Although many objects positive for epithelial cell adhesion molecules and cytokeratin (EpCAM+CK+) are not counted as CTC, they may be an important predictor for survival. We evaluated the association between these objects and survival in patients with prostate cancer. Patients and methods: Included in this follow-up study were 179 patients with castration-resistant prostate cancer. CellSearch was used to isolate EpCAM+ objects and to stain DNA, cytokeratin and CD45. All EpCAM+CK+ objects were subdivided into seven classes on the basis of predefined morphological appearance in 63 independent samples. Association of each class with survival was studied using Kaplan–Meier and Cox regression analyses. Results: Each EpCAM+CK+CD45− class showed a strong association with overall survival (P < 0.001). This included small tumor microparticles (S-TMP), which did not require a nucleus and thus are unable to metastasize. A higher number of objects in any class was associated with decreased survival. A good prediction model included large tumor cell fragments (L-TCF), age, hemoglobin and lactate dehydrogenase. Models with S-TMP or CTC instead of L-TCF performed similarly. Conclusion: EpCAM+CK+CD45− that do not meet strict definitions for CTC are strong prognostic markers for survival
Original languageUndefined
Pages (from-to)1851-1857
JournalAnnals of oncology
Volume21
Issue number9
DOIs
Publication statusPublished - 2010

Keywords

  • IR-76782
  • METIS-265371

Cite this

@article{eb4a86402ffe40aabb783ee0b45aef8d,
title = "All circulating EpCAM+CK+CD45- objects predict overall survival in castration-resistant prostate cancer",
abstract = "Background: Presence of five or more circulating tumor cells (CTC) in patients with metastatic carcinomas is associated with poor survival. Although many objects positive for epithelial cell adhesion molecules and cytokeratin (EpCAM+CK+) are not counted as CTC, they may be an important predictor for survival. We evaluated the association between these objects and survival in patients with prostate cancer. Patients and methods: Included in this follow-up study were 179 patients with castration-resistant prostate cancer. CellSearch was used to isolate EpCAM+ objects and to stain DNA, cytokeratin and CD45. All EpCAM+CK+ objects were subdivided into seven classes on the basis of predefined morphological appearance in 63 independent samples. Association of each class with survival was studied using Kaplan–Meier and Cox regression analyses. Results: Each EpCAM+CK+CD45− class showed a strong association with overall survival (P < 0.001). This included small tumor microparticles (S-TMP), which did not require a nucleus and thus are unable to metastasize. A higher number of objects in any class was associated with decreased survival. A good prediction model included large tumor cell fragments (L-TCF), age, hemoglobin and lactate dehydrogenase. Models with S-TMP or CTC instead of L-TCF performed similarly. Conclusion: EpCAM+CK+CD45− that do not meet strict definitions for CTC are strong prognostic markers for survival",
keywords = "IR-76782, METIS-265371",
author = "F.A.W. Coumans and F.A.W. Coumans and Doggen, {Catharina Jacoba Maria} and G. Attard and {de Bono}, J.S. and Terstappen, {Leonardus Wendelinus Mathias Marie}",
year = "2010",
doi = "10.1093/annonc/mdq030",
language = "Undefined",
volume = "21",
pages = "1851--1857",
journal = "Annals of oncology",
issn = "0923-7534",
publisher = "Oxford University Press",
number = "9",

}

All circulating EpCAM+CK+CD45- objects predict overall survival in castration-resistant prostate cancer. / Coumans, F.A.W.; Coumans, F.A.W.; Doggen, Catharina Jacoba Maria; Attard, G.; de Bono, J.S.; Terstappen, Leonardus Wendelinus Mathias Marie.

In: Annals of oncology, Vol. 21, No. 9, 2010, p. 1851-1857.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - All circulating EpCAM+CK+CD45- objects predict overall survival in castration-resistant prostate cancer

AU - Coumans, F.A.W.

AU - Coumans, F.A.W.

AU - Doggen, Catharina Jacoba Maria

AU - Attard, G.

AU - de Bono, J.S.

AU - Terstappen, Leonardus Wendelinus Mathias Marie

PY - 2010

Y1 - 2010

N2 - Background: Presence of five or more circulating tumor cells (CTC) in patients with metastatic carcinomas is associated with poor survival. Although many objects positive for epithelial cell adhesion molecules and cytokeratin (EpCAM+CK+) are not counted as CTC, they may be an important predictor for survival. We evaluated the association between these objects and survival in patients with prostate cancer. Patients and methods: Included in this follow-up study were 179 patients with castration-resistant prostate cancer. CellSearch was used to isolate EpCAM+ objects and to stain DNA, cytokeratin and CD45. All EpCAM+CK+ objects were subdivided into seven classes on the basis of predefined morphological appearance in 63 independent samples. Association of each class with survival was studied using Kaplan–Meier and Cox regression analyses. Results: Each EpCAM+CK+CD45− class showed a strong association with overall survival (P < 0.001). This included small tumor microparticles (S-TMP), which did not require a nucleus and thus are unable to metastasize. A higher number of objects in any class was associated with decreased survival. A good prediction model included large tumor cell fragments (L-TCF), age, hemoglobin and lactate dehydrogenase. Models with S-TMP or CTC instead of L-TCF performed similarly. Conclusion: EpCAM+CK+CD45− that do not meet strict definitions for CTC are strong prognostic markers for survival

AB - Background: Presence of five or more circulating tumor cells (CTC) in patients with metastatic carcinomas is associated with poor survival. Although many objects positive for epithelial cell adhesion molecules and cytokeratin (EpCAM+CK+) are not counted as CTC, they may be an important predictor for survival. We evaluated the association between these objects and survival in patients with prostate cancer. Patients and methods: Included in this follow-up study were 179 patients with castration-resistant prostate cancer. CellSearch was used to isolate EpCAM+ objects and to stain DNA, cytokeratin and CD45. All EpCAM+CK+ objects were subdivided into seven classes on the basis of predefined morphological appearance in 63 independent samples. Association of each class with survival was studied using Kaplan–Meier and Cox regression analyses. Results: Each EpCAM+CK+CD45− class showed a strong association with overall survival (P < 0.001). This included small tumor microparticles (S-TMP), which did not require a nucleus and thus are unable to metastasize. A higher number of objects in any class was associated with decreased survival. A good prediction model included large tumor cell fragments (L-TCF), age, hemoglobin and lactate dehydrogenase. Models with S-TMP or CTC instead of L-TCF performed similarly. Conclusion: EpCAM+CK+CD45− that do not meet strict definitions for CTC are strong prognostic markers for survival

KW - IR-76782

KW - METIS-265371

U2 - 10.1093/annonc/mdq030

DO - 10.1093/annonc/mdq030

M3 - Article

VL - 21

SP - 1851

EP - 1857

JO - Annals of oncology

JF - Annals of oncology

SN - 0923-7534

IS - 9

ER -