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Postoperative Detection of Circulating Tumor Cells Predicts Tumor Recurrence in Colorectal Cancer Patients

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

Circulating tumor cells are thought to play a crucial role in the development of distant metastases. Their detection in the blood of colorectal cancer patients may be linked to poor outcome, but current evidence is controversial.

Materials and Methods

Pre- and postoperative flow cytometric analysis of blood samples was carried out in 76 colorectal cancer patients undergoing surgical resection. The EpCAM/CD326 epithelial surface antigen was used to identify circulating tumor cells.

Results

Fifty-four (71 %) patients showed circulating tumor cells preoperatively, and all metastatic patients showed high levels of circulating tumor cells. Surgical resection resulted in a significant decrease in the levels of circulating tumor cells. Among 69 patients undergoing radical surgery, 16 had high postoperative levels of circulating tumor cells, and 12 (75 %) experienced tumor recurrence. High postoperative level of circulating tumor cells was the only independent variable related to cancer relapse. In patients without circulating tumor cells, the progression-free survival rate increased from 16 to 86 %, with a reduction in the risk of tumor relapse greater than 90 %.

Conclusions

High postoperative levels of circulating tumor cells accurately predicted tumor recurrence, suggesting that assessment of circulating tumor cells could optimize tailored management of colorectal cancer patients.

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Authors and Affiliations

  1. Division of Surgical Oncology—“F. Magrassi - A. Lanzara” Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, c/o II Policlinico, Edificio 17, Via Pansini 5, 80131, Naples, Italy

    Gennaro Galizia, Anna Zamboli, Paolo Castellano, Andrea Mabilia, Annamaria Auricchio & Eva Lieto

  2. CEINGE—Advanced Biotechnologies, Naples, Italy

    Marica Gemei & Luigi Del Vecchio

  3. Division of Medical Oncology - “F. Magrassi - A. Lanzara” Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, Naples, Italy

    Michele Orditura & Ferdinando De Vita

  4. Division of Internal Medicine, Allergy and Clinical Immunology, Department of Medical and Surgical Sciences, Second University of Naples School of Medicine, Naples, Italy

    Ciro Romano

  5. Department of Biochemistry and Medical Biotechnologies (DBBM), University of Naples ‘Federico II’, Naples, Italy

    Luigi Del Vecchio

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  1. Gennaro Galizia
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  2. Marica Gemei
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Correspondence to Gennaro Galizia.

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Author names in bold designate shared co-first authorship.

Gennaro Galizia and Marica Gemei contributed equally to this work.

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Galizia, G., Gemei, M., Orditura, M. et al. Postoperative Detection of Circulating Tumor Cells Predicts Tumor Recurrence in Colorectal Cancer Patients. J Gastrointest Surg 17, 1809–1818 (2013). https://doi.org/10.1007/s11605-013-2258-6

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