In vitro detection of occult bone marrow metastases in patients with colorectal cancer hepatic metastases.
OBJECTIVE
The purpose of this study was to assess the immunocytochemical status of bone marrow aspirates from patients with clinically isolated hepatic metastases to test the hypothesis that such findings would allow improved patient selection for liver-directed treatment.


METHODS
All patients had biopsy-proven or presumed colorectal cancer metastatic to the liver and were scheduled for an operative procedure for hepatic resection or for hepatic artery catheter and chemotherapy pump implant. Immunocytochemical analysis of bone marrow aspirate smears was performed with a panel of monoclonal antibodies directed toward cytokeratins, Lewis Y antigen and A-33 colorectal epitopes.


RESULTS
Data from 80 patients indicated that bone marrow reactivity was present in 9.5 percent of those with resectable hepatic metastases and in 34 percent of those not resected (P = 0.03). No single monoclonal antibody or combination produced better discrimination.


CONCLUSIONS
Presence or absence of presumed occult colorectal cancer cells in the bone marrow of patients with isolated hepatic metastases is biologically interesting, but not useful in selecting or altering patient management.
Cohen
A M
AM
Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York 10021, USA.
Garin-Chesa
P
P
Hanson
M
M
Weyhrauch
K
K
Kemeny
N
N
Fong
Y
Y
Paty
P
P
Welt
S
S
Old
L
L
D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor / Q000032:analysis; D001853:Bone Marrow / Q000473:pathology; D001856:Bone Marrow Examination; D019046:Bone Marrow Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D006801:Humans; D007124:Immunoenzyme Techniques; D007633:Keratins / Q000032:analysis; D007983:Lewis Blood Group Antigens / Q000032:analysis; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D011379:Prognosis
D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor; D007983:Lewis Blood Group Antigens; C094162:Lewis Y antigen; D007633:Keratins