TY - JOUR
T1 - Frequency and clinical impact of preoperative circulating tumor cells in resectable non-metastatic lung adenocarcinomas
AU - Dandachi, Nadia
AU - Tiran, Verena
AU - Lindenmann, Joerg
AU - Brcic, Luka
AU - Fink-Neuboeck, Nicole
AU - Kashofer, Karl
AU - Absenger, Gudrun
AU - Bezan, Angelika
AU - Cote, Richard J.
AU - Datar, Ram
AU - Balic, Marija
N1 - Funding Information:
This work was supported by funds of the Oesterreichische Nationalbank, Anniversary Fund , project number 14246 (MB) and by the Clinical Research Grant of the Austrian Society of Hematology and Medical Oncology (VT).
Publisher Copyright:
© 2017 Elsevier B.V.
PY - 2017/11
Y1 - 2017/11
N2 - 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.
AB - 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.
KW - Circulating tumor cells
KW - Lung cancer
KW - Non-metastatic
KW - Preoperative
KW - Recurrence
UR - http://www.scopus.com/inward/record.url?scp=85030980878&partnerID=8YFLogxK
U2 - 10.1016/j.lungcan.2017.10.003
DO - 10.1016/j.lungcan.2017.10.003
M3 - Article
C2 - 29110843
AN - SCOPUS:85030980878
SN - 0169-5002
VL - 113
SP - 152
EP - 157
JO - Lung Cancer
JF - Lung Cancer
ER -