Frequency and clinical impact of preoperative circulating tumor cells in resectable non-metastatic lung adenocarcinomas

Nadia Dandachi, Verena Tiran, Joerg Lindenmann, Luka Brcic, Nicole Fink-Neuboeck, Karl Kashofer, Gudrun Absenger, Angelika Bezan, Richard J. Cote, Ram Datar, Marija Balic

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Objectives Despite successful surgery, 30–50% of patients with resectable non-small cell lung cancer develop tumor recurrence within 5 years of surgery. Materials and methods In this prospective study, we performed CTC enumerations in 40 patients with non-metastatic lung adenocarcinoma (NMLA) using a size-based microfilter. Additionally, cfDNA isolated from plasma was analyzed in 35 out of 40 patients. Results CTCs were identified in 15 out of 40 patients (37.5%) with a range of 1–44 cells, whereas mutated cfDNA was only detected in 3 out of 35 patients (8.6%). Disease-free survival (DFS) was significantly associated with CTC positivity (log-rank p = 0.025), grading (log-rank p = 0.019), tumor stage (log-rank p = 0.025) and lymph node status (log-rank p = 0.029). Multivariate analysis, including tumor stage and grading, showed that CTC positivity (p = 0.006), grading (0.039) and tumor stage (p = 0.022) were independently associated with DFS. Conclusion Our study found that microfilter-based CTC enumeration in NMLA patients is an independent predictor of worse DFS. The used NGS-based cfDNA characterization had limited sensitivity to be clinically informative in our study cohort. CTC assessment before surgery can thus identify NMLA patients at high risk of disease recurrence.

Original languageEnglish
Pages (from-to)152-157
Number of pages6
JournalLung Cancer
StatePublished - Nov 2017


  • Circulating tumor cells
  • Lung cancer
  • Non-metastatic
  • Preoperative
  • Recurrence


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