Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 7/2013

01-07-2013 | Colorectal Cancer

Circulating Tumor Cells and Prognosis of Patients with Resectable Colorectal Liver Metastases or Widespread Metastatic Colorectal Cancer: A Meta-Analysis

Authors: Bas Groot Koerkamp, MD, PhD, Nuh N. Rahbari, MD, Markus W. Büchler, MD, Moritz Koch, MD, Jürgen Weitz, MD

Published in: Annals of Surgical Oncology | Issue 7/2013

Login to get access

Abstract

Background

We performed a systematic review and meta-analysis to investigate the prognostic value of tumor cells in blood (circulating tumor cells [CTCs]) or bone marrow (BM) (disseminated tumor cells) of patients with resectable colorectal liver metastases or widespread metastatic colorectal cancer (CRC).

Materials and Methods

The following databases were searched in May 2011: MEDLINE, EMBASE, Science Citation Index, BIOSIS, Cochrane Library. Studies that investigated the association between tumor cells in blood or BM and long-term outcome in patients with metastatic CRC were included. We extracted hazard ratios (HRs) and confidence intervals (CIs) from the included studies and performed random-effects meta-analyses for survival outcomes.

Results

The literature search yielded 16 studies representing 1,491 patients. The results of 12 studies representing 1,329 patients were suitable for pooled analysis. The overall survival (HR, 2.47; 95 % CI 1.74–3.51) and progression-free survival (PFS) (HR, 2.07; 95 % CI 1.44–2.98) were worse in patients with CTCs. The subgroup of studies with more than 35 % CTC-positive patients was the only subgroup with a statistically significant worse PFS. All eight studies that performed multivariable analysis identified the detection of CTCs as an independent prognostic factor for survival.

Conclusion

The detection of CTCs in peripheral blood of patients with resectable colorectal liver metastases or widespread metastatic CRC is associated with disease progression and poor survival.
Appendix
Available only for authorised users
Literature
1.
2.
3.
Arnold D, Seufferlein T. Targeted treatments in colorectal cancer: state of the art and future perspectives. Gut. 2010;59:838–58.PubMedCrossRef
4.
de Haas RJ, Wicherts DA, Andreani P, Pascal G, Saliba F, Ichai P, et al. Impact of expanding criteria for resectability of colorectal metastases on short- and long-term outcomes after hepatic resection. Ann Surg. 2011;253:1069–79.PubMedCrossRef
5.
Rahbari NN, Aigner M, Thorlund K, Mollberg N, Motschall E, Jensen K, et al. Meta-analysis shows that detection of circulating tumor cells indicates poor prognosis in patients with colorectal cancer. Gastroenterology. 2010;138:1714–26.PubMedCrossRef
6.
Cohen SJ, Punt CJ, Iannotti N, Saidman BH, Sabbath KD, Gabrail NY, et al. Prognostic significance of circulating tumor cells in patients with metastatic colorectal cancer. Ann Oncol. 2009;20:1223–9.PubMedCrossRef
7.
Vlems FA, Diepstra JH, Punt CJ, Ligtenberg MJ, Cornelissen IM, van Krieken JH, et al. Detection of disseminated tumour cells in blood and bone marrow samples of patients undergoing hepatic resection for metastasis of colorectal cancer. Br J Surg. 2003;90:989–95.PubMedCrossRef
8.
Schoppmeyer K, Fruhauf N, Oldhafer K, Seeber S, Kasimir-Bauer S. Tumor cell dissemination in colon cancer does not predict extrahepatic recurrence in patients undergoing surgery for hepatic metastases. Oncol Rep. 2006;15:449–54.PubMed
9.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6:e1000100.PubMedCrossRef
10.
Cohen SJ, Alpaugh RK, Gross S, O’Hara SM, Smirnov DA, Terstappen LW, et. al. Isolation and characterization of circulating tumor cells in patients with metastatic colorectal cancer. Clin Colorectal Cancer. 2006;6:125–32.PubMedCrossRef
11.
Gazzaniga P, Gradilone A, Petracca A, Nicolazzo C, Raimondi C, Iacovelli R, et al. Molecular markers in circulating tumour cells from metastatic colorectal cancer patients. J Cell Mol Med. 2010;14:2073–7.PubMedCrossRef
12.
Rahbari NN, Reissfelder C, Muhlbayer M, Weidmann K, Kahlert C, Büchler MW, et al. Correlation of circulating angiogenic factors with circulating tumor cells and disease recurrence in patients undergoing curative resection for colorectal liver metastases. Ann Surg Oncol. 2011;18:2182–91.PubMedCrossRef
13.
Tierney JF, Stewart LA, Ghersi D, Burdett S, Sydes MR. Practical methods for incorporating summary time-to-event data into meta-analysis. Trials. 2007;8:16.PubMedCrossRef
14.
Hiraiwa K, Takeuchi H, Hasegawa H, Saikawa Y, Suda K, Ando T, et al. Clinical significance of circulating tumor cells in blood from patients with gastrointestinal cancers. Ann Surg Oncol. 2008;15:3092–100.PubMedCrossRef
15.
Koch M, Kienle P, Hinz U, Antolovic D, Schmidt J, Herfarth C, et al. Detection of hematogenous tumor cell dissemination predicts tumor relapse in patients undergoing surgical resection of colorectal liver metastases. Ann Surg. 2005;241:199–205.PubMedCrossRef
16.
Königsberg R, Gneist M, Jahn-Kuch D, Pfeiler G, Hager G, Hudec M, et al. Circulating tumor cells in metastatic colorectal cancer: efficacy and feasibility of different enrichment methods. Cancer Lett. 2010;293:117–23.PubMedCrossRef
17.
Matsusaka S, Suenaga M, Mishima Y, Kuniyoshi R, Takagi K, Terui Y, et al. Circulating tumor cells as a surrogate marker for determining response to chemotherapy in Japanese patients with metastatic colorectal cancer. Cancer Sci. 2011;102:1188–92.PubMedCrossRef
18.
Papavasiliou P, Fisher T, Kuhn J, Nemunaitis J, Lamont J. Circulating tumor cells in patients undergoing surgery for hepatic metastases from colorectal cancer. Baylor Univ Med Cent Proc. 2010;23:11–4.
19.
Staritz P, Kienle P, Koch M, Benner A, von Knebel Doeberitz M, Rudi J, et al. Detection of disseminated tumour cells as a potential surrogate-marker for monitoring palliative chemotherapy in colorectal cancer patients. J Exp Clin Cancer Res. 2004;23:633–9.PubMed
20.
Tol J, Koopman M, Miller MC, Tibbe A, Cats A, Creemers GJ, et al. Circulating tumour cells early predict progression-free and overall survival in advanced colorectal cancer patients treated with chemotherapy and targeted agents. Ann Oncol. 2010;21:1006–12.PubMedCrossRef
21.
Vogelaar FJ, Mesker WE, Rijken AM, van Pelt GW, van Leeuwen AM, Tanke HJ, et al. Clinical impact of different detection methods for disseminated tumor cells in bone marrow of patients undergoing surgical resection of colorectal liver metastases: a prospective follow-up study. BMC Cancer. 2010;10:153.PubMedCrossRef
22.
Wyld DK, Selby P, Perren TJ, Jonas SK, Allen-Mersh TG, Wheeldon J, et al. Detection of colorectal cancer cells in peripheral blood by reverse-transcriptase polymerase chain reaction for cytokeratin 20. Int J Cancer. 1998;79:288–93.PubMedCrossRef
23.
Yen LC, Yeh YS, Chen CW, Wang HM, Tsai HL, Lu CY, et al. Detection of KRAS oncogene in peripheral blood as a predictor of the response to cetuximab plus chemotherapy in patients with metastatic colorectal cancer. Clin Cancer Res. 2009;15:4508–13.PubMedCrossRef
24.
Poston GJ, Figueras J, Giuliante F, Nuzzo G, Sobrero AF, Gigot JF, et. al. Urgent need for a new staging system in advanced colorectal cancer. J Clin Oncol. 2008;26:4828–33.PubMedCrossRef
25.
Denlinger CS, Cohen SJ. Progress in the development of prognostic and predictive markers for gastrointestinal malignancies. Curr Treat Options Oncol. 2007;8:339–51.PubMedCrossRef
26.
Nagrath S, Sequist LV, Maheswaran S, Bell DW, Irimia D, Ulkus L, et al. Isolation of rare circulating tumour cells in cancer patients by microchip technology. Nature. 2007;450:1235–9.PubMedCrossRef
Metadata
Title
Circulating Tumor Cells and Prognosis of Patients with Resectable Colorectal Liver Metastases or Widespread Metastatic Colorectal Cancer: A Meta-Analysis
Authors
Bas Groot Koerkamp, MD, PhD
Nuh N. Rahbari, MD
Markus W. Büchler, MD
Moritz Koch, MD
Jürgen Weitz, MD
Publication date
01-07-2013
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 7/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-013-2907-8

Other articles of this Issue 7/2013

Annals of Surgical Oncology 7/2013 Go to the issue

Breast Oncology

Rare Breast Cancer: 933 Adenoid Cystic Carcinomas from the National Cancer Data Base

Breast Oncology

Clinical Usefulness of AJCC Response Criteria for Neoadjuvant Chemotherapy in Breast Cancer

Melanomas

Desmoplastic Melanoma: Is There a Role for Sentinel Lymph Node Biopsy?

Gastrointestinal Oncology

Changes in Postoperative Recurrence and Prognostic Risk Factors for Patients with Gastric Cancer who Underwent Curative Gastric Resection during Different Time Periods

Breast Oncology

Cost-Effectiveness of Radioguided Occult Lesion Localization (ROLL) Versus Wire-Guided Localization (WGL) in Breast Conserving Surgery for Nonpalpable Breast Cancer: Results from a Randomized Controlled Multicenter Trial

Healthcare Policy and Outcomes

Deprivation and Colorectal Cancer Surgery: Longer-Term Survival Inequalities are Due to Differential Postoperative Mortality Between Socioeconomic Groups