Detection of Circulating Tumor Cells in Locally Advanced High-risk Prostate Cancer During Neoadjuvant Chemotherapy and Radical Prostatectomy

Anticancer Res. 2015 Oct;35(10):5679-85.

Abstract

Aim: Circulating tumour cells (CTCs) may be prognostic for biochemical recurrence-free survival (bRFS) in patients with locally advanced high-risk prostate cancer (LAPC) undergoing neoadjuvant chemohormonal therapy (NCHT) and radical prostatectomy (RP).

Patients and methods: CTCs were detected before and after NCHT, after RP and at follow-up using the CellSearch™-System for 59 blood samples (20 ml) from patients with LAPC (n=15) and, additionally, for 15 control samples.

Results: The median 5-year progression risk was 90%. CTCs (≥1/20 ml) were detected in 53.3% of patients, with a detection rate of 18.6% in sample-adjusted analysis. CTCs were detected at baseline in 20% of patients with LAPC and 6.7% of controls (p=0.6). CTC findings displayed no association with clinicopathological characteristics. The median bRFS of CTC-negative vs. CTC-positive patients was 43.7 (95% confidence interval not reached) vs. 29.2 months (95% confidence interval=26.8-60.6 months), without statistical significance (p=0.76).

Conclusion: During NCHT and RP, longitudinal CTC presence seems to some extent stochastic, although patients with persistant CTCs post-RP developed biochemical recurrence. No significant association with clinicopathological characteristics or bRFS was observed in patients with LAPC, despite a trend for reduced bRFS in patients with detectable CTCs.

Keywords: Biomarkers; CTCs; circulating tumor cells; molecular marker; prostate cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Combined Modality Therapy
  • Disease Progression
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Neoadjuvant Therapy / mortality*
  • Neoplasm Grading
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Recurrence, Local / therapy
  • Neoplasm Staging
  • Neoplastic Cells, Circulating / pathology*
  • Prognosis
  • Prospective Studies
  • Prostatectomy / mortality*
  • Prostatic Neoplasms / mortality
  • Prostatic Neoplasms / pathology*
  • Prostatic Neoplasms / therapy
  • Risk Factors
  • Survival Rate