The effects of preoperative chemotherapy on isolated tumour cells in the blood and bone marrow of gastric cancer patients.
Recent studies in breast cancer suggest that monitoring the isolated tumour cells (ITC) may be used as a surrogate marker to evaluate the efficacy of systemic chemotherapy. In the present study, we have investigated the effects of preoperative chemotherapy on ITC in the blood and bone marrow of patients with potentially resectable gastric cancer. After sorting out the CD45-positive cells, the presence of ITC defined as cytokeratin-positive cells was examined before and after preoperative chemotherapy. The patients received two courses of preoperative chemotherapy with cisplatin (100 mg m(-2), day 1) and 5-fluorouracil (1000 mg m(-2), days 1-5), administered every 28 days. Fourteen of 32 (44%) patients initially diagnosed with ITC in blood and/or bone marrow were found to be negative (responders) after preoperative chemotherapy (P<0.01). The incidence of ITC in bone marrow was also significantly (P<0.01) reduced from 97 (31 of 32) to 53% (17 of 32). The difference between patients positive for ITC in the blood before (n=7, 22%) and after (n=5, 16%) chemotherapy was statistically insignificant. The overall 3-year survival rates were 32 and 49% in the responders and non-responders, respectively (P=0.683). These data indicate that preoperative chemotherapy can reduce the incidence of ITC in patients with gastric cancer.
Kolodziejczyk
P
P
1st Department of Surgery, Jagiellonian University Medical College, 40 Kopernika Street, Krakow 31-501, Poland.
Pituch-Noworolska
A
A
Drabik
G
G
Kulig
J
J
Szczepanik
A
A
Sierzega
M
M
Gurda
A
A
Popiela
T
T
Zembala
M
M
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001853:Bone Marrow / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D016009:Chi-Square Distribution; D002945:Cisplatin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D053208:Kaplan-Meier Estimate; D017493:Leukocyte Common Antigens / Q000097:blood; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D011300:Preoperative Care / Q000379:methods; D013274:Stomach Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
D017493:Leukocyte Common Antigens; C516769:PTPRC protein, human; D002945:Cisplatin; D005472:Fluorouracil
Surg Today. 2005;35(6):436-41
15912289
Semin Oncol. 2005 Dec;32(6 Suppl 9):S105-8
16399445
Int J Cancer. 2006 Jun 1;118(11):2877-81
16381016
Breast Cancer Res. 2006;8(5):R60
17062129
Ann Surg Oncol. 2007 Feb;14(2):373-80
17080240
Anticancer Res. 2007 Jan-Feb;27(1B):635-40
17348453
Br J Cancer. 1999 Nov;81(5):870-3
10555760
Surgery. 2001 Jan;129(1):15-22
11150029
Ann Surg. 2001 Feb;233(2):189-94
11176124
Eur J Cardiothorac Surg. 2001 May;19(5):576-9
11343934
Br J Cancer. 2002 Apr 8;86(7):1047-51
11953846
J Surg Res. 2004 Mar;117(1):121-6
15013722
World J Gastroenterol. 2004 Mar 15;10(6):804-8
15040021
J Clin Oncol. 1996 Jun;14(6):1810-7
8656249
Clin Cancer Res. 1998 Sep;4(9):2129-34
9748130
Anticancer Res. 1998 Sep-Oct;18(5B):3747-52
9854488
Gastroenterology. 1999 Mar;116(3):543-8
10029612
Int J Cancer. 2005 Mar 10;114(1):94-100
15523696
J Exp Clin Cancer Res. 2004 Dec;23(4):633-9
15743034