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Langenbeck's Archives of Surgery
Erschienen in: Langenbeck's Archives of Surgery 5/2005

01.09.2005 | New Surgical Horizons

Detection and clinical implications of minimal residual disease in gastro-intestinal cancer

verfasst von: Fabian Wolfrum, Ilka Vogel, Fred Fändrich, Holger Kalthoff

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 5/2005

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Abstract

Introduction

Metastatic dissemination is an important factor for the prognosis of patients with gastro-intestinal cancer. Exact staging is crucial to determine appropriate multimodal therapeutic strategies. At present, the sensitivity of routinely performed diagnostic techniques is suboptimal for the detection of minimal residual disease (MRD) and occult metastases since the number of disseminated tumour cells (DTCs) is mostly marginal. To amend the verification of DTCs, immunohistochemical and molecular methods were applied to retrieve epithelial cell-specific proteins in non-epithelial tissue of different body compartments or fluids. Many groups have eagerly focussed on the identification of new markers and novel tests, yet specificity and sensitivity of these methods as well as robustness in the clinical setting are frequently missing.

Materials and methods

This review critically evaluates the prognostic impact of MRD in patients with pancreatic, colorectal and gastric cancer by outlining those studies showing diagnostic results of DTC detection in lymph nodes, bone marrow, venous blood and peritoneal lavage, some of which present novel strategies.

Conclusion

The analysed data concerning MRD in gastro-intestinal cancers reveal that results are undesirably heterogeneous. From a critical point of view, many clinical studies missed their chance because of small cohort size; moreover, methodological standardisation is generally lacking. On the other hand, the very encouraging results achieved so far, together with the comprehensive analyses of a few research groups, foster the prediction that DTC/MRD issues will soon expand the standard TNM classification.
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Metadaten
Titel
Detection and clinical implications of minimal residual disease in gastro-intestinal cancer
verfasst von
Fabian Wolfrum
Ilka Vogel
Fred Fändrich
Holger Kalthoff
Publikationsdatum
01.09.2005
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 5/2005
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-005-0558-3

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