Long term survival following the detection of circulating tumour cells in head and neck squamous cell carcinoma.
BACKGROUND
Techniques for detecting circulating tumor cells in the peripheral blood of patients with head and neck cancers may identify individuals likely to benefit from early systemic treatment.


METHODS
Reconstruction experiments were used to optimise immunomagnetic enrichment and RT-PCR detection of circulating tumor cells using four markers (ELF3, CK19, EGFR and EphB4). This method was then tested in a pilot study using samples from 16 patients with advanced head and neck carcinomas.


RESULTS
Seven patients were positive for circulating tumour cells both prior to and after surgery, 4 patients were positive prior to but not after surgery, 3 patients were positive after but not prior to surgery and 2 patients were negative. Two patients tested positive for circulating cells but there was no other evidence of tumor spread. Given this patient cohort had mostly advanced disease, as expected the detection of circulating tumour cells was not associated with significant differences in overall or disease free survival.


CONCLUSIONS
For the first time, we show that almost all patients with advanced head and neck cancers have circulating cells at the time of surgery. The clinical application of techniques for detection of spreading disease, such as the immunomagnetic enrichment RT-PCR analysis used in this study, should be explored further.
Winter
Stuart C
SC
Department of Otolaryngology, Head and Neck Surgery, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia, 5000, Australia. stuartcwinter@googlemail.com
Stephenson
Sally-Anne
SA
Subramaniam
Selva K
SK
Paleri
Vinidh
V
Ha
Kien
K
Marnane
Conor
C
Krishnan
Suren
S
Rees
Guy
G
D014408:Biomarkers, Tumor / Q000032:analysis / Q000097:blood; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000401:mortality / Q000473:pathology*; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology*; D006801:Humans; D018189:Immunomagnetic Separation / Q000379:methods; D053208:Kaplan-Meier Estimate; D008297:Male; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011379:Prognosis; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods
D014408:Biomarkers, Tumor