Prognostic value of postoperative detection of blood circulating tumor cells in patients with colorectal cancer operated on for cure.
OBJECTIVE
To assess whether postoperative detection of circulating tumor cells in peripheral blood influenced the prognosis of patients with colorectal cancer after radical surgery.


BACKGROUND
In a previous study, the authors demonstrated that baseline detection of blood circulating tumor cells does not have prognostic significance in patients with colorectal cancer. However, surgical procedures may increase tumor cell detachment and mobilization.


METHODS
Sixty-six patients with histologically confirmed colorectal cancer operated on for cure were included in this study. Circulating tumor cells were detected by means of reverse transcriptase-polymerase chain reaction targeting to carcinoembryonic antigen messenger RNA in peripheral blood samples obtained 24 hours after surgery. Endpoints of the study were tumor recurrence, overall survival, and cancer-related survival. Univariate (Kaplan-Meier method) and multivariate (Cox regression model) analyses were performed.


RESULTS
After a median follow-up of 36 months, 15 patients (23%) had tumor relapse and 14 had died (21%), 8 of them from a cancer-related cause. Cox regression analysis identified lymph node metastases and gender as independent predictors of tumor recurrence and cancer-related survival, whereas overall survival was dependent on the degree of differentiation of the primary tumor. More importantly, the presence of circulating tumor cells after surgery had no prognostic influence on tumor recurrence, overall survival, or cancer-related survival.


CONCLUSIONS
Postoperative detection of blood circulating tumor cells had no prognostic significance in patients with colorectal cancer operated on for cure.
Bessa
Xavier
X
Department of Gastroenterology, Institut de Malalties Digestives, Hospital Clínic, IDIBAPS, University of Barcelona, Catalonia, Spain.
Piñol
Virgínia
V
Castellví-Bel
Sergi
S
Piazuelo
Elena
E
Lacy
Antonio M
AM
Elizalde
J Ignasi
JI
Piqué
Josep M
JM
Castells
Antoni
A
D000368:Aged; D002272:Carcinoembryonic Antigen / Q000097:blood; D002277:Carcinoma / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D009360:Neoplastic Cells, Circulating; D011379:Prognosis; D012044:Regression Analysis; D012307:Risk Factors; D015996:Survival Rate
D002272:Carcinoembryonic Antigen