title: Clinical impact of circulating tumor cells and therapy response in pancreatic cancer.
abstract: Among gastrointestinal cancers, the prognosis of pancreatic cancer is one of the poorest, with a large number of patients being diagnosed with unresectable tumors at the first visit to a doctor. The aims of the present study were to investigate the circulating tumor cells (CTC) in peripheral blood in order to assess their clinical significance in patients with pancreatic cancer.
  
  
  
  Sixty-five patients with advanced pancreatic cancer were enrolled. Borderline resectable pancreatic tumor patients were 9, and Unresectable patients were 56. The CellSearch system was used to isolate and enumerate CTCs.
  
  
  
  CTCs were identified in 21 out of 65 patients (32.3%) with only unresectable tumors. The overall survival rate was significantly lower in unresectable patients with than in those without CTCs (P = 0.0051). CTC positivity was significantly higher in patients with than in those without liver metastasis. A multivariate analysis identified the presence or absence of CTCs as an independent prognostic factor. Follow-up blood specimens were obtained from 40 patients treated with chemotherapy or chemoradiotherapy. The incidences of CTC positivity at three months after beginning of treatments in patients with progressive disease and stable disease or a partial response were 45.4% and 24.1%, respectively. The overall survival rate was significantly lower in patients with than in those without CTCs even after treatments (P = 0.045).
  
  
  
  CTC numbers represents a useful tool for predicting prognoses and therapeutic responses to chemotherapy among patients with advanced pancreatic cancer.
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan. Electronic address: ok0627@m2.kufm.kagoshima-u.ac.jp.
authors.forename: Keishi
authors.initials: K
authors.lastname: Okubo
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Uenosono
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Arigami
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Mataki
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Matsushita
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan.
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Yanagita
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kurahara
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sakoda
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kijima
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan.
authors.forename: Kosei
authors.initials: K
authors.lastname: Maemura
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating; D010094:Oxonic Acid / Q000627:therapeutic use; D010190:Pancreatic Neoplasms / Q000097:blood / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D005641:Tegafur / Q000627:therapeutic use; D000093542:Gemcitabine
chemical_list: D000970:Antineoplastic Agents; D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000093542:Gemcitabine
keywords: Chemotherapy and chemoradiotherapy; Circulating tumor cells; Liquid biopsy; Pancreatic cancer; The CellSearch system