title: The Prognostic Role of Circulating Tumor Cells (CTC) in High-risk Non-muscle-invasive Bladder Cancer.
abstract: The purpose of this study was to evaluate the impact of circulating tumor cells (CTCs) as a prognostic marker in patients with high-risk non-muscle-invasive bladder cancer (NMIBC) and assess the efficacy and reliability of 2 different CTC isolation methods.
  
  
  
  Globally, 155 patients with a pathologically confirmed diagnosis of high-risk NMIBC were included (pT1G3 with or without carcinoma in situ) and underwent transurethral resection of bladder tumor (TURB) after a blood withdrawal for CTC evaluation. A total of 101 patients (Group A) had their samples analyzed with the CellSearch automated system, and 54 (Group B) had their samples analyzed with the CELLection Dynabeads manual system.
  
  
  
  Patients were followed for 28 months, and during this interval, there were a total of 65 (41.9%) recurrences, 27 (17.4%) disease progressions, and 9 (5.8%) lymph node and/or bone metastasis. In our CTC analysis, there were 20 (19.8%) positive patients in Group A and 24 in Group B (44.4%). In our analysis, we found a strong correlation between CTC presence and time to first recurrence; in Group A, we observed an incidence of recurrence in 75% of CTC-positive patients and in Group B of 83% of CTC-positive patients. The time to progression was also strongly correlated with CTCs: 65% and 29%, respectively, of those patients who progressed in those with CTCs in Group A and B.
  
  
  
  The study demonstrates the potential role of CTCs as a prognostic marker for risk stratification in patients with NMIBC, to predict both recurrence and progression.
authors.affiliation: Department of Gynecological-Obstetrics Sciences and Urological Sciences, Sapienza Rome University Policlinico Umberto I, Rome, Italy.
authors.forename: Gian Maria
authors.initials: GM
authors.lastname: Busetto
authors.affiliation: Department of Urology, European Institute of Oncology (IEO), Milan, Italy. Electronic address: matteo.ferro@ieo.it.
authors.forename: Matteo
authors.initials: M
authors.lastname: Ferro
authors.affiliation: Department of Gynecological-Obstetrics Sciences and Urological Sciences, Sapienza Rome University Policlinico Umberto I, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Del Giudice
authors.affiliation: Department of Gynecological-Obstetrics Sciences and Urological Sciences, Sapienza Rome University Policlinico Umberto I, Rome, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Antonini
authors.affiliation: Department of Urology, Stanford University Medical Center, Stanford, CA.
authors.forename: Benjamin I
authors.initials: BI
authors.lastname: Chung
authors.affiliation: Biostatistical Unit, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Isabella
authors.initials: I
authors.lastname: Sperduti
authors.affiliation: Biostatistical Unit, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Diana
authors.initials: D
authors.lastname: Giannarelli
authors.affiliation: Department of Emergency and Organ Transplantation, Urology, Andrology, and Kidney Transplantation Unit, University of Bari, Bari, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lucarelli
authors.affiliation: Department of Urology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Borghesi
authors.affiliation: Department of Urology, European Institute of Oncology (IEO), Milan, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Musi
authors.affiliation: Department of Urology, European Institute of Oncology (IEO), Milan, Italy.
authors.forename: Ottavio
authors.initials: O
authors.lastname: de Cobelli
authors.affiliation: Department of Gynecological-Obstetrics Sciences and Urological Sciences, Sapienza Rome University Policlinico Umberto I, Rome, Italy.
authors.forename: Ettore
authors.initials: E
authors.lastname: De Berardinis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*
keywords: CELLection; CellSearch; NMIBC; Prognosis; TURB