Prognostic significance of circulating tumor cells in patients with metastatic colorectal cancer
Prognostic significance of circulating tumor cells in patients with metastatic colorectal cancer
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DOI：
10.1093/annonc/mdn786
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发表时间：
2009-07-01
影响因子：
50.5
通讯作者：
Meropol, N. J.
中科院分区：
文献类型：
--
作者：
Cohen, S. J.;Punt, C. J. A.;Meropol, N. J.
患者和方法：在基线和治疗时，用免疫磁性分离法从430例mCRC患者的血液中计数CTC。分别基于>= 3或< 3个CTC/7.5 ml的CTC水平将患者分为不利和有利预后组。通过治疗线、肝脏受累、奥沙利铂、伊立替康或贝伐单抗的接受、年龄和东部肿瘤协作组体力状态（ECOG PS）对亚组进行分析。存活患者的中位随访时间为25.8个月。对于所有患者，不利基线CTC的无进展生存期（PFS）和总生存期（OS）短于有利基线CTC（PFS为4.4 vs 7.8 m，P = 0.004; OS为9.4 vs 20.6 m，P < 0.0001）。在所有患者亚组中，不良基线CTC与较差OS相关（P < 0.001）。接受一线或二线治疗的患者（P = 0.003），伊立替康（P = 0.0001），肝脏受累（P = 0.002），≥ 65岁（P = 0.0007），ECOG PS为0（P = 0.04），不良基线CTC与较差PFS相关。基线CTC计数是根据治疗或患者特征定义的特定亚组中的重要预后因素。
Patients and methods: CTCs were enumerated with immunomagnetic separation from the blood of 430 patients with mCRC at baseline and on therapy. Patients were stratified into unfavorable and favorable prognostic groups based on CTC levels of >= 3 or < 3 CTCs/7.5 ml, respectively. Subgroups were analyzed by line of treatment, liver involvement, receipt of oxaliplatin, irinotecan, or bevacizumab, age, and Eastern Cooperative Oncology Group performance status (ECOG PS).Results: Seventy-one percent of deaths have occurred. Median follow-up for living patients is 25.8 months. For all patients, progression-free survival (PFS) and overall survival (OS) for unfavorable compared with favorable baseline CTCs is shorter (4.4 versus 7.8 m, P = 0.004 for PFS; 9.4 versus 20.6 m, P < 0.0001 for OS). In all patient subgroups, unfavorable baseline CTC was associated with inferior OS (P < 0.001). In patients receiving first- or second-line therapy (P = 0.003), irinotecan (P = 0.0001), having liver involvement (P = 0.002), >= 65 years (P = 0.0007), and ECOG PS of zero (P = 0.04), unfavorable baseline CTC was associated with inferior PFS.Conclusion: Baseline CTC count is an important prognostic factor within specific subgroups defined by treatment or patient characteristics.