title: Role of circulating tumor cells as prognostic marker in resected stage III colorectal cancer.
abstract: BACKGROUND
  The prognostic role of circulating tumor cells (CTC) in early colorectal cancer (CRC) has not been determined yet. We evaluated the potential prognostic value of CTC in stage III CRC patients.
  
  
  METHODS
  Prospective multicenter study of 519 patients with stage III CRC recruited between January 2009 and June 2010. CTC were enumerated with the CellSearch System after primary tumor resection and before the start of adjuvant therapy. A total of 472 patients were included in the analysis.
  
  
  RESULTS
  CTC ≥1, ≥2, ≥3 and ≥5 were detected in 166 (35%), 93 (20%), 57 (12%) and 34 (7%) patients, respectively. Median follow-up was 40 months. In the overall population, CTC ≥1 (disease-free survival (DFS): HR 0.97, P = 0.85; overall survival (OS): HR 1.03, P = 0.89), ≥2 (DFS: HR 1.07, P = 0.76; OS: HR 1.02, P = 0.95), ≥3 (DFS: HR 0.96, P = 0.87; OS: HR 0.74, P = 0.41) and ≥5 (DFS: HR 0.72, P = 0.39; OS: HR 0.48, P = 0.21) were not associated with worse DFS and OS. No clinicopathological characteristics were significantly associated with the presence of CTC. In patients with disease relapse, the proportion with CTC ≥1 was not significantly different between those with single versus multiple metastatic locations (37.9% versus 31.4%, P = 0.761). In the multivariate analysis, CTC ≥1 was not an independent prognostic factor for DFS (HR 0.97, P = 0.87) and OS (HR 0.96, P = 0.89).
  
  
  CONCLUSIONS
  CTC detection was not associated with worse DFS and OS in patients with stage III CRC. Given the scarcity of CTC in these patients, it is likely that CTC determined by CellSearch system does not have a prognostic role in this setting. However, a longer follow-up is needed.
authors.affiliation: Department of Medical Oncology.
authors.forename: M J
authors.initials: MJ
authors.lastname: Sotelo
authors.affiliation: Department of Medical Oncology.
authors.forename: J
authors.initials: J
authors.lastname: Sastre
authors.affiliation: Department of Clinical Analysis, Hospital Universitario Clínico San Carlos, Madrid.
authors.forename: M L
authors.initials: ML
authors.lastname: Maestro
authors.affiliation: Department of Clinical Analysis, Hospital Universitario Clínico San Carlos, Madrid.
authors.forename: S
authors.initials: S
authors.lastname: Veganzones
authors.affiliation: Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo.
authors.forename: J M
authors.initials: JM
authors.lastname: Viéitez
authors.affiliation: Department of Medical Oncology, Hospital Universitario Miguel Servet, Zaragoza.
authors.forename: V
authors.initials: V
authors.lastname: Alonso
authors.affiliation: Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid.
authors.forename: C
authors.initials: C
authors.lastname: Grávalos
authors.affiliation: Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza.
authors.forename: P
authors.initials: P
authors.lastname: Escudero
authors.affiliation: Department of Medical Oncology, Complejo Hospitalario de Navarra, Pamplona.
authors.forename: R
authors.initials: R
authors.lastname: Vera
authors.affiliation: Department of Medical Oncology, Hospital Reina Sofía, Universidad de Córdoba, Maimonides Institute of Biomedical Research (IMIBIC), Córdoba.
authors.forename: E
authors.initials: E
authors.lastname: Aranda
authors.affiliation: Department of Medical Oncology, Hospital Universitario Gregorio Marañón, Madrid.
authors.forename: P
authors.initials: P
authors.lastname: García-Alfonso
authors.affiliation: Department of Medical Oncology, Hospital Universitario de Elche, Elche.
authors.forename: J
authors.initials: J
authors.lastname: Gallego-Plazas
authors.affiliation: Department of Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander.
authors.forename: C
authors.initials: C
authors.lastname: Lopez
authors.affiliation: Department of Medical Oncology, Corporació Sanitària Universitària Parc Taulí, Sabadell.
authors.forename: C
authors.initials: C
authors.lastname: Pericay
authors.affiliation: Department of Medical Oncology, Hospital Son Llatzer, Palma de Mallorca.
authors.forename: A
authors.initials: A
authors.lastname: Arrivi
authors.affiliation: Department of Medical Oncology, Hospital de Granollers, Granollers.
authors.forename: P
authors.initials: P
authors.lastname: Vicente
authors.affiliation: Department of Medical Oncology, Hospital Universitario Virgen de las Nieves, Granada.
authors.forename: P
authors.initials: P
authors.lastname: Ballesteros
authors.affiliation: Department of Medical Oncology, Hospital Vall d́Hebrón, Barcelona.
authors.forename: E
authors.initials: E
authors.lastname: Elez
authors.affiliation: Department of Medical Oncology, Hospital Universitario de Valme, Sevilla, Spain.
authors.forename: A
authors.initials: A
authors.lastname: López-Ladrón
authors.affiliation: Department of Medical Oncology edíazrubio.hcsc@salud.madrid.org.
authors.forename: E
authors.initials: E
authors.lastname: Díaz-Rubio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D015179:Colorectal Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000378:metabolism*; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D014408:Biomarkers, Tumor
keywords: circulating tumor cells; colorectal cancer; prognostic marker; stage III