title: Perioperative Search for Circulating Tumor Cells in Patients Undergoing Prostate Brachytherapy for Clinically Nonmetastatic Prostate Cancer.
abstract: Despite the absence of local prostate cancer recurrence, some patients develop distant metastases after prostate brachytherapy. We evaluate whether prostate brachytherapy procedures have a potential risk for hematogenous spillage of prostate cancer cells. Fifty-nine patients who were undergoing high-dose-rate (HDR) or low-dose-rate (LDR) brachytherapy participated in this prospective study. Thirty patients with high-risk or locally advanced cancer were treated with HDR brachytherapy after neoadjuvant androgen deprivation therapy (ADT). Twenty-nine patients with clinically localized cancer were treated with LDR brachytherapy without neoadjuvant ADT. Samples of peripheral blood were drawn in the operating room before insertion of needles (preoperative) and again immediately after the surgical manipulation (intraoperative). Blood samples of 7.5 mL were analyzed for circulating tumor cells (CTCs) using the CellSearch System. While no preoperative samples showed CTCs (0%), they were detected in intraoperative samples in 7 of the 59 patients (11.8%; preoperative vs. intraoperative,p= 0.012). Positive CTC status did not correlate with perioperative variables, including prostate-specific antigen (PSA) at diagnosis, use of neoadjuvant ADT, type of brachytherapy, Gleason score, and biopsy positive core rate. We detected CTCs from samples immediately after the surgical manipulation. Further study is needed to evaluate whether those CTCs actually can survive and proliferate at distant sites.
authors.affiliation: Department of Urology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan. tsumura@med.kitasato-u.ac.jp.
authors.forename: Hideyasu
authors.initials: H
authors.lastname: Tsumura
authors.affiliation: Department of Urology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan. tsatoh@kitasato-u.ac.jp.
authors.forename: Takefumi
authors.initials: T
authors.lastname: Satoh
authors.affiliation: Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan. hishiyam@kitasato-u.ac.jp.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Ishiyama
authors.affiliation: Department of Urology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan. ktabata@med.kitasato-u.ac.jp.
authors.forename: Ken-Ichi
authors.initials: KI
authors.lastname: Tabata
authors.affiliation: Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan. takenaka@kitasato-u.ac.jp.
authors.forename: Kouji
authors.initials: K
authors.lastname: Takenaka
authors.affiliation: Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan. akane.o.enaka@gmail.com.
authors.forename: Akane
authors.initials: A
authors.lastname: Sekiguchi
authors.affiliation: Department of Microbiology, Kitasato University School of Allied Health Sciences, Kanagawa 252-0373, Japan. nakamu7@mac.com.
authors.forename: Masaki
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan. m-kitano@jcom.home.ne.jp.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kitano
authors.affiliation: Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan. hayakazu@med.kitasato-u.ac.jp.
authors.forename: Kazushige
authors.initials: K
authors.lastname: Hayakawa
authors.affiliation: Department of Urology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan. miwamura@med.kitasato-u.ac.jp.
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Iwamura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001918:Brachytherapy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D059035:Perioperative Period; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy*; D011879:Radiotherapy Dosage
keywords: brachytherapy; circulating tumor cell; prostate cancer