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Title: Circulating Tumor Cells as an Independent Predictor of Survival in Advanced Gastric Cancer.
Authors: Okabe, H
Tsunoda, S  kyouindb  KAKEN_id
Hosogi, H
Hisamori, S  kyouindb  KAKEN_id
Tanaka, E
Tanaka, S
Sakai, Y
Author's alias: 岡部, 寛
Issue Date: Nov-2015
Publisher: Springer US
Journal title: Annals of surgical oncology
Volume: 22
Issue: 12
Start page: 3954
End page: 3961
Abstract: [Background]When the indication for surgery of highly advanced gastric cancer is considered, careful selection of the patients is important. In addition to tumor-node-metastasis factors and peritoneal lavage cytology (CY), which are important predictors of prognosis, detection of circulating tumor cells (CTCs) could be another potential marker. [Methods]This study prospectively evaluated CTCs using a semi-automated immunomagnetic separation system (CellSearch) for 136 patients with advanced gastric cancer to determine the frequency of CTC positivity. For 123 patients who also had their CY evaluated, the significance of both CTC and CY, was investigated as a potential biomarker to predict progression-free survival (PFS) or to monitor the therapeutic effect. [Results]In 25 patients (18.4 %), CTCs were positive. Positive CTC counts were more common for tumors with diffuse histologic type and distant metastasis. The PFS of CTC-positive patients was significantly shorter than that of CTC-negative patients (hazard ratio 2.03; P = 0.016). A multivariate analysis of 123 patients showed that CTC and CY as well as performance status and macroscopic distant metastasis were independent factors for PFS. When both CTC and CY were converted to negative values by therapeutic interventions, long-term PFS was achieved. [Conclusions]Detection of CTCs was an independent predictor of a shorter PFS in advanced gastric cancer. For selecting patients who require intensive treatment, CTCs could be a valuable biomarker. The combined status of CTC and CY would be useful in selecting patients for radical surgery. Further investigation with a larger number of patients is necessary to establish the importance of CTCs.
Description: First online: 17 March 2015
Rights: The final publication is available at Springer via
The full-text file will be made open to the public on 17 March 2016 in accordance with publisher's 'Terms and Conditions for Self-Archiving'.
この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。This is not the published version. Please cite only the published version.
DOI(Published Version): 10.1245/s10434-015-4483-6
PubMed ID: 25777087
Appears in Collections:Journal Articles

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