Circulating Tumour Cells as an Independent Prognostic Factor in Patients with Advanced Oesophageal Squamous Cell Carcinoma Undergoing Chemoradiotherapy

• Published in: Scientific reports Vol. 6; no. 1; p. 31423
• Main Authors: Su, Po-Jung, Wu, Min-Hsien, Wang, Hung-Ming, Lee, Chia-Lin, Huang, Wen-Kuan, Wu, Chiao-En, Chang, Hsien-Kun, Chao, Yin-Kai, Tseng, Chen-Kan, Chiu, Tzu-Keng, Lin, Nina Ming-Jung, Ye, Siou-Ru, Lee, Jane Ying-Chieh, Hsieh, Chia-Hsun
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 17.08.2016; Nature Publishing Group
• Subjects: 13; 13/51; 14/63; 631/67/1059/485; 631/67/1059/99; 692/4028; 692/53/2422; Adult; Aged; Carcinoma, Squamous Cell - blood; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - therapy; Chemoradiotherapy; Chemotherapy; Disease-Free Survival; Esophageal cancer; Esophageal Neoplasms - blood; Esophageal Neoplasms - mortality; Esophageal Neoplasms - therapy; Esophageal Squamous Cell Carcinoma; Esophagus; Female; Flow cytometry; Humanities and Social Sciences; Humans; Male; Medical prognosis; Medicin och hälsovetenskap; Middle Aged; multidisciplinary; Multivariate analysis; Negative selection; Neoplastic Cells, Circulating - metabolism; Neoplastic Cells, Circulating - pathology; Radiation therapy; Science; Science (multidisciplinary); Squamous cell carcinoma; Surgery; Survival; Survival Rate; Tumors
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/srep31423

The role of circulating tumour cells (CTCs) in advanced oesophageal cancer (EC) patients undergoing concurrent chemoradiotherapy (CCRT) remains uncertain. A negative selection protocol plus flow cytometry was validated to efficiently identify CTCs. The CTC number was calculated and analysed for survival impact. The protocol’s efficacy in CTC identification was validated with a recovery rate of 44.6 ± 9.1% and a coefficient of variation of 20.4%. Fifty-seven patients and 20 healthy donors were enrolled. Initial staging, first response to CRT, and surgery after CRT were prognostic for overall survival, with P values of <0.0001, <0.0001, and <0.0001, respectively. The CTC number of EC patients is significantly higher (P = 0.04) than that of healthy donors. Multivariate analysis for disease-specific progression-free survival showed that surgery after response to CCRT, initial stage, and CTC number (≥21.0 cells/mL) played independent prognostic roles. For overall survival, surgery after CCRT, performance status, initial stage, and CTC number were significant independent prognostic factors. In conclusion, a negative selection plus flow cytometry protocol efficiently detected CTCs. The CTC number before CCRT was an independent prognostic factor in patients with unresectable oesophageal squamous cell carcinoma. Further large-scale prospective studies for validation are warranted.