title: The prognostic role of circulating tumor cells in heavily pretreated individuals with a low life expectancy.
abstract: OBJECTIVE
  Studies of circulating tumor cells (CTCs) have generally recruited individuals with newly diagnosed metastatic cancer, with recent data also indicating their prognostic value in the adjuvant setting. Their role in dying patients has not been established.
  
  
  METHODS
  CTCs were measured in 43 individuals with metastatic breast cancer estimated to have less than 6 months to live who had exhausted standard therapeutic options.
  
  
  RESULTS
  Those with a CTC count of ≤ 100 had a median of 182 days to live, compared with those with a CTC count of >100 who had a median of 17 days until death (p = 0.009, log rank, HR: 3.1, 95% CI: 1.4-7.3).
  
  
  CONCLUSIONS
  A CTC count of >100 is associated with imminent death. Provided external validity is demonstrated, such information would be useful for patients and their families who often request specific prognostic clarity and could improve the quality of end-of-life care.
authors.affiliation: The Departments of Medical Oncology & Palliative Care, Imperial College & Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, UK.
authors.forename: Justin
authors.initials: J
authors.lastname: Stebbing
authors.forename: Victoria
authors.initials: V
authors.lastname: Harding
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Urch
authors.forename: Thomas
authors.initials: T
authors.lastname: Kaier
authors.forename: Guy
authors.initials: G
authors.lastname: Schofield
authors.forename: Matthew
authors.initials: M
authors.lastname: Flook
authors.forename: Constantine
authors.initials: C
authors.lastname: Alifrangis
authors.forename: Anna-Mary
authors.initials: AM
authors.lastname: Young
authors.forename: Jacqueline A
authors.initials: JA
authors.lastname: Shaw
authors.forename: R Charles
authors.initials: RC
authors.lastname: Coombes
authors.forename: Jonathan
authors.initials: J
authors.lastname: Krell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D001943:Breast Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000473:pathology; D002452:Cell Count; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008017:Life Expectancy; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor
keywords: biomarker; cancer; circulating tumor cell; cut-off >100; hospice; life expectancy; overall survival; palliative