Importance of circulating tumor cells in newly diagnosed colorectal cancer

Guus van Dalum, Marco R. de Groot, Grrit-Jan Stam, Loes F.A. Scholten, Walter J.B. Mastboom, Istvan Vermes, Leon W.M.M. Terstappen

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Abstract

Background: The presence of circulating tumor cells (CTC) is associated with poor prognosis in patients with metastatic colorectal cancer (CRC). This study was conducted to determine if the presence of CTC prior to surgery and during follow-up in patients with newly diagnosed non-metastatic CRC identifies patients who are at risk for disease recurrence.

Methods: In a prospective single center study 183 patients with newly diagnosed non-disseminated CRC scheduled for surgery were enrolled from 2003 till 2008 and followed up for a median of 5.1 years. CTC were enumerated with the CellSearch System in 4 aliquots of 7.5 ml of peripheral blood before and after surgery (1-26 weeks), after adjuvant therapy and 1, 2, 3 and 4 years after surgery.

Findings: ≥1 CTC/ 30ml of blood were detected in 44 (24%) patients before surgery. CTC frequency did not change significantly at the time points after surgery. Patients with CTC before surgery had a significant decrease in Recurrence Free Survival (RFS, logrank test p=0.014) and Colon Cancer Related Survival (CCRS, p=0.002). Five year RFS dropped from 75% to 61% and five year CCRS from 83% to 69% for patients with CTC before surgery. In a multivariate analysis of CTC, T-Stage and N-stage, the presence of CTC and N-stage remained as significant factors for RFS and CCRS. Surprisingly the presence of CTC after surgery was not significantly associated with RFS and CCRS whereas CTC 2-3 years after surgery was again significantly associated with RFS and CCRS.

Interpretation: The presence of CTC in patients with stage I-III CRC before surgery is associated with a significant reduction RFS and CCRS. Although similar amounts of CTC were detected within 3 months after surgery they were not associated with RFS or CCRS. In contrast CTC were again highly significant for RFS and CCRS 2-3 years after surgery. These findings suggest a role of CTC detection, to assess which patients need adjuvant treatment. To implement CTC detection in the non-metastatic setting a validated CTC detection technology is needed with increased sensitivity and specificity.
Original languageEnglish
DOIs
Publication statusPublished - 2014
Event105th AACR Annual Meeting 2014 - San Diego, United States
Duration: 5 Apr 20149 Apr 2014
Conference number: 105

Conference

Conference105th AACR Annual Meeting 2014
CountryUnited States
CitySan Diego
Period5/04/149/04/14

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Circulating Neoplastic Cells
Colorectal Neoplasms
Recurrence
Survival

Keywords

  • METIS-307079

Cite this

van Dalum, G., de Groot, M. R., Stam, G-J., Scholten, L. F. A., Mastboom, W. J. B., Vermes, I., & Terstappen, L. W. M. M. (2014). Importance of circulating tumor cells in newly diagnosed colorectal cancer. Poster session presented at 105th AACR Annual Meeting 2014, San Diego, United States. https://doi.org/10.1158/1538-7445.AM2014-3064
van Dalum, Guus ; de Groot, Marco R. ; Stam, Grrit-Jan ; Scholten, Loes F.A. ; Mastboom, Walter J.B. ; Vermes, Istvan ; Terstappen, Leon W.M.M. / Importance of circulating tumor cells in newly diagnosed colorectal cancer. Poster session presented at 105th AACR Annual Meeting 2014, San Diego, United States.
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title = "Importance of circulating tumor cells in newly diagnosed colorectal cancer",
abstract = "Background: The presence of circulating tumor cells (CTC) is associated with poor prognosis in patients with metastatic colorectal cancer (CRC). This study was conducted to determine if the presence of CTC prior to surgery and during follow-up in patients with newly diagnosed non-metastatic CRC identifies patients who are at risk for disease recurrence.Methods: In a prospective single center study 183 patients with newly diagnosed non-disseminated CRC scheduled for surgery were enrolled from 2003 till 2008 and followed up for a median of 5.1 years. CTC were enumerated with the CellSearch System in 4 aliquots of 7.5 ml of peripheral blood before and after surgery (1-26 weeks), after adjuvant therapy and 1, 2, 3 and 4 years after surgery.Findings: ≥1 CTC/ 30ml of blood were detected in 44 (24{\%}) patients before surgery. CTC frequency did not change significantly at the time points after surgery. Patients with CTC before surgery had a significant decrease in Recurrence Free Survival (RFS, logrank test p=0.014) and Colon Cancer Related Survival (CCRS, p=0.002). Five year RFS dropped from 75{\%} to 61{\%} and five year CCRS from 83{\%} to 69{\%} for patients with CTC before surgery. In a multivariate analysis of CTC, T-Stage and N-stage, the presence of CTC and N-stage remained as significant factors for RFS and CCRS. Surprisingly the presence of CTC after surgery was not significantly associated with RFS and CCRS whereas CTC 2-3 years after surgery was again significantly associated with RFS and CCRS.Interpretation: The presence of CTC in patients with stage I-III CRC before surgery is associated with a significant reduction RFS and CCRS. Although similar amounts of CTC were detected within 3 months after surgery they were not associated with RFS or CCRS. In contrast CTC were again highly significant for RFS and CCRS 2-3 years after surgery. These findings suggest a role of CTC detection, to assess which patients need adjuvant treatment. To implement CTC detection in the non-metastatic setting a validated CTC detection technology is needed with increased sensitivity and specificity.",
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van Dalum, G, de Groot, MR, Stam, G-J, Scholten, LFA, Mastboom, WJB, Vermes, I & Terstappen, LWMM 2014, 'Importance of circulating tumor cells in newly diagnosed colorectal cancer' 105th AACR Annual Meeting 2014, San Diego, United States, 5/04/14 - 9/04/14, . https://doi.org/10.1158/1538-7445.AM2014-3064

Importance of circulating tumor cells in newly diagnosed colorectal cancer. / van Dalum, Guus ; de Groot, Marco R.; Stam, Grrit-Jan; Scholten, Loes F.A.; Mastboom, Walter J.B.; Vermes, Istvan; Terstappen, Leon W.M.M.

2014. Poster session presented at 105th AACR Annual Meeting 2014, San Diego, United States.

Research output: Contribution to conferencePosterOther research output

TY - CONF

T1 - Importance of circulating tumor cells in newly diagnosed colorectal cancer

AU - van Dalum, Guus

AU - de Groot, Marco R.

AU - Stam, Grrit-Jan

AU - Scholten, Loes F.A.

AU - Mastboom, Walter J.B.

AU - Vermes, Istvan

AU - Terstappen, Leon W.M.M.

PY - 2014

Y1 - 2014

N2 - Background: The presence of circulating tumor cells (CTC) is associated with poor prognosis in patients with metastatic colorectal cancer (CRC). This study was conducted to determine if the presence of CTC prior to surgery and during follow-up in patients with newly diagnosed non-metastatic CRC identifies patients who are at risk for disease recurrence.Methods: In a prospective single center study 183 patients with newly diagnosed non-disseminated CRC scheduled for surgery were enrolled from 2003 till 2008 and followed up for a median of 5.1 years. CTC were enumerated with the CellSearch System in 4 aliquots of 7.5 ml of peripheral blood before and after surgery (1-26 weeks), after adjuvant therapy and 1, 2, 3 and 4 years after surgery.Findings: ≥1 CTC/ 30ml of blood were detected in 44 (24%) patients before surgery. CTC frequency did not change significantly at the time points after surgery. Patients with CTC before surgery had a significant decrease in Recurrence Free Survival (RFS, logrank test p=0.014) and Colon Cancer Related Survival (CCRS, p=0.002). Five year RFS dropped from 75% to 61% and five year CCRS from 83% to 69% for patients with CTC before surgery. In a multivariate analysis of CTC, T-Stage and N-stage, the presence of CTC and N-stage remained as significant factors for RFS and CCRS. Surprisingly the presence of CTC after surgery was not significantly associated with RFS and CCRS whereas CTC 2-3 years after surgery was again significantly associated with RFS and CCRS.Interpretation: The presence of CTC in patients with stage I-III CRC before surgery is associated with a significant reduction RFS and CCRS. Although similar amounts of CTC were detected within 3 months after surgery they were not associated with RFS or CCRS. In contrast CTC were again highly significant for RFS and CCRS 2-3 years after surgery. These findings suggest a role of CTC detection, to assess which patients need adjuvant treatment. To implement CTC detection in the non-metastatic setting a validated CTC detection technology is needed with increased sensitivity and specificity.

AB - Background: The presence of circulating tumor cells (CTC) is associated with poor prognosis in patients with metastatic colorectal cancer (CRC). This study was conducted to determine if the presence of CTC prior to surgery and during follow-up in patients with newly diagnosed non-metastatic CRC identifies patients who are at risk for disease recurrence.Methods: In a prospective single center study 183 patients with newly diagnosed non-disseminated CRC scheduled for surgery were enrolled from 2003 till 2008 and followed up for a median of 5.1 years. CTC were enumerated with the CellSearch System in 4 aliquots of 7.5 ml of peripheral blood before and after surgery (1-26 weeks), after adjuvant therapy and 1, 2, 3 and 4 years after surgery.Findings: ≥1 CTC/ 30ml of blood were detected in 44 (24%) patients before surgery. CTC frequency did not change significantly at the time points after surgery. Patients with CTC before surgery had a significant decrease in Recurrence Free Survival (RFS, logrank test p=0.014) and Colon Cancer Related Survival (CCRS, p=0.002). Five year RFS dropped from 75% to 61% and five year CCRS from 83% to 69% for patients with CTC before surgery. In a multivariate analysis of CTC, T-Stage and N-stage, the presence of CTC and N-stage remained as significant factors for RFS and CCRS. Surprisingly the presence of CTC after surgery was not significantly associated with RFS and CCRS whereas CTC 2-3 years after surgery was again significantly associated with RFS and CCRS.Interpretation: The presence of CTC in patients with stage I-III CRC before surgery is associated with a significant reduction RFS and CCRS. Although similar amounts of CTC were detected within 3 months after surgery they were not associated with RFS or CCRS. In contrast CTC were again highly significant for RFS and CCRS 2-3 years after surgery. These findings suggest a role of CTC detection, to assess which patients need adjuvant treatment. To implement CTC detection in the non-metastatic setting a validated CTC detection technology is needed with increased sensitivity and specificity.

KW - METIS-307079

U2 - 10.1158/1538-7445.AM2014-3064

DO - 10.1158/1538-7445.AM2014-3064

M3 - Poster

ER -

van Dalum G, de Groot MR, Stam G-J, Scholten LFA, Mastboom WJB, Vermes I et al. Importance of circulating tumor cells in newly diagnosed colorectal cancer. 2014. Poster session presented at 105th AACR Annual Meeting 2014, San Diego, United States. https://doi.org/10.1158/1538-7445.AM2014-3064