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International Journal of Colorectal Disease

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01-09-2014 | Original Article

Detection of circulating tumor cells in patients with locally advanced rectal cancer undergoing neoadjuvant therapy followed by curative surgery

Authors: Elena Magni, Edoardo Botteri, Paola S. Ravenda, Maria C. Cassatella, Emilio Bertani, Antonio Chiappa, Fabrizio Luca, Laura Zorzino, Paolo Pietro Bianchi, Laura Adamoli, Maria T. Sandri, Maria G. Zampino

Published in: International Journal of Colorectal Disease | Issue 9/2014

Abstract

Purpose

Circulating tumor cells (CTCs) represent an independent prognostic factor in metastatic colorectal cancer, while their significance in early stages is still an open issue. The aim of the study is to investigate the role of CTCs in rectal cancer patients undergoing neoadjuvant chemoradiotherapy (CT-RT).

Methods

In this prospective single institutional study, cT3–4 and/or N+ rectal cancer was treated with neoadjuvant CT-RT. The primary endpoints were as follows: evaluation of CTCs at baseline (t0), after CT-RT (t1), within 7 days after surgery (t2), and at 6 months from surgery (t3) and correlation with main patient/tumor characteristics, CEA, response to neoadjuvant therapy, and disease-free survival (DFS). CTCs were enumerated with the CellSearch System in 22.5 ml peripheral blood. A repeated measure analysis for binary outcome was used to evaluate over time changes in the percentage of CTCs detectable in blood samples.

Results

Of the 90 patients enrolled in this study, 85 were eligible consisting of 52 males and 33 females. Median age was 63 years and median follow-up was 38 months. CTCs were available for all patients at t0, for 67 at t1, for 68 at t2, and for 62 at t3. CTCs >0 were reported on 16 (19 %) at t0, on 5 (7.5 %) at t1, on 6 (9 %) at t2, and on 3 (5 %) at t3 (P value for trend 0.039). Only for CT-RT responders, CTCs reduced from t0 to t1. No statistically significant association was found between CTCs and main patient/tumor characteristics and DFS.

Conclusions

Sixteen patients (19 %) had CTCs ≥1 at t0 with reduction in CTC number in case of objective remissions. The proportion of patients with CTCs ≥1 decreased over the time as the therapeutic course proceeded. Much effort should be oriented toward increasing CTC detection rate by enhancing technical tests and achieving better patient characterization.

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Title: Detection of circulating tumor cells in patients with locally advanced rectal cancer undergoing neoadjuvant therapy followed by curative surgery
Authors: Elena Magni
Edoardo Botteri
Paola S. Ravenda
Maria C. Cassatella
Emilio Bertani
Antonio Chiappa
Fabrizio Luca
Laura Zorzino
Paolo Pietro Bianchi
Laura Adamoli
Maria T. Sandri
Maria G. Zampino
Publication date: 01-09-2014
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 9/2014
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-014-1958-z

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Springer Medicine

Detection of circulating tumor cells in patients with locally advanced rectal cancer undergoing neoadjuvant therapy followed by curative surgery

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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