title: Clinical significance of circulating tumor cells in peripheral blood from patients with gastric cancer.
abstract: BACKGROUND
  The authors hypothesized that circulating tumor cells (CTCs) in patients with gastric cancer are associated with prognosis and disease recurrence. In this study, they evaluated CTCs in gastric cancer and clarified the clinical impact of CTCs.
  
  
  METHODS
  In total, 265 consecutive patients with gastric cancer were enrolled. Fourteen patients were excluded from the analysis, including 12 patients who another cancer and 2 patients who refused the treatment. The remaining 251 patients were divided into 2 groups: 148 patients who underwent gastrectomy (the resection group) and 103 patients who did not undergo gastrectomy (the nonresectable group). Peripheral blood samples were collected before gastrectomy or chemotherapy. A proprietary test for capturing, identifying, and counting CTCs in blood was used for the isolation and enumeration of CTCs.
  
  
  RESULTS
  CTCs were detected in 16 patients (10.8%) from the resection group and in 62 patients (60.2%) from the nonresectable group. The overall survival rate for the entire cohort was significantly lower in patients with CTCs than in those without CTCs (P < .0001). In the resection group, relapse-free and overall survival in patients with CTCs was significantly lower than in patients without CTCs (P < .0001). It was noteworthy that the expression of CTCs was an independent factor for determining the overall survival of patients with gastric cancer in multivariate analysis (P = .024). In the nonresectable group, the overall survival rate was significantly lower in patients with CTCs than in those without CTCs (P = .0044).
  
  
  CONCLUSIONS
  The evaluation of CTCs in peripheral blood may be a useful tool for predicting tumor progression, prognosis, and the effect of chemotherapy in patients with gastric cancer.
authors: Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Kagoshima, Japan.
authors: Yoshikazu
authors: Y
authors: Uenosono
authors: Takaaki
authors: T
authors: Arigami
authors: Tsutomu
authors: T
authors: Kozono
authors: Shigehiro
authors: S
authors: Yanagita
authors: Takahiko
authors: T
authors: Hagihara
authors: Naoto
authors: N
authors: Haraguchi
authors: Daisuke
authors: D
authors: Matsushita
authors: Munetsugu
authors: M
authors: Hirata
authors: Hideo
authors: H
authors: Arima
authors: Yawara
authors: Y
authors: Funasako
authors: Yuko
authors: Y
authors: Kijima
authors: Akihiro
authors: A
authors: Nakajo
authors: Hiroshi
authors: H
authors: Okumura
authors: Sumiya
authors: S
authors: Ishigami
authors: Shuichi
authors: S
authors: Hokita
authors: Shinichi
authors: S
authors: Ueno
authors: Shoji
authors: S
authors: Natsugoe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D045744:Cell Line, Tumor; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000473:pathology; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D013274:Stomach Neoplasms / Q000097:blood* / Q000473:pathology*; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor
keywords: circulating tumor cells; gastric cancer; hematogenous recurrence; peritoneal dissemination; prognosis