Annals of Surgical Oncology

, Volume 19, Issue 8, pp 2539–2546

Disseminated Tumor Cells in the Bone Marrow Negatively Influence Survival after Resection of Colorectal Liver Metastases

  • Sebastian Hinz
  • Jessica Bockhorst
  • Christian Röder
  • Jan-Hendrik Egberts
  • Clemens Schafmayer
  • Thomas Küchler
  • Thomas Becker
  • Holger Kalthoff
Hepatobiliary Tumors

DOI: 10.1245/s10434-012-2291-9

Cite this article as:
Hinz, S., Bockhorst, J., Röder, C. et al. Ann Surg Oncol (2012) 19: 2539. doi:10.1245/s10434-012-2291-9

Abstract

Background

Despite all efforts in extending the resectability rates of colorectal liver metastases, thus improving the prognosis of the patients, tumor recurrence occurs in many patients. Occult dissemination of tumor cells might reflect a minimal residual disease that is not eliminated by primary surgery. Because the prognostic effect of disseminated tumor cells (DTC) is still uncertain in this clinical setting, we analyzed these cells in the peripheral blood and bone marrow of patients undergoing hepatic resection of colorectal liver metastases.

Methods

In 108 patients with colorectal liver metastases, the presence of DTC in the peripheral blood and bone marrow was detected with CK20 RT-PCR. Clinical data were prospectively collected, and multiple variables were analyzed regarding their influence on overall survival.

Results

DTC in the peripheral blood were detected in 40% of the patients. In 25% of the patients, DTC were detected in the bone marrow. The median follow-up was 34 months. Fifty-nine of 108 patients died from tumor relapse. Multivariate analysis determined detection of DTC in the bone marrow to be an independent prognostic factors for overall survival (P = 0.038).

Conclusions

This large series of patients with hepatic resection of colorectal liver metastases demonstrated that detection of CK20-positive DTC via RT-PCR in the bone marrow compartment negatively influences overall survival. The evidence of DTC in the bone marrow might serve as an additional individual marker to select patients for adjuvant treatment after liver metastases resection.

Copyright information

© Society of Surgical Oncology 2012

Authors and Affiliations

  • Sebastian Hinz
    • 1
  • Jessica Bockhorst
    • 1
  • Christian Röder
    • 2
  • Jan-Hendrik Egberts
    • 1
  • Clemens Schafmayer
    • 1
  • Thomas Küchler
    • 3
  • Thomas Becker
    • 1
  • Holger Kalthoff
    • 2
  1. 1.Department of General and Thoracic SurgeryUniversity Hospital Schleswig-HolsteinKielGermany
  2. 2.Division of Molecular Oncology, Institute for Experimental Cancer Research, Comprehensive Cancer Center NorthUniversity Hospital Schleswig-HolsteinKielGermany
  3. 3.Reference Center for Quality of Life in OncologyUniversity Hospital Schleswig-HolsteinKielGermany

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