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Journal of Cancer Research and Clinical Oncology

Erschienen in:

01.05.2013 | Original Paper

Detection of circulating tumor cells in different stages of prostate cancer

verfasst von: Mark Thalgott, Brigitte Rack, Tobias Maurer, Michael Souvatzoglou, Matthias Eiber, Veronika Kreß, Matthias M. Heck, Ulrich Andergassen, Roman Nawroth, Jürgen E. Gschwend, Margitta Retz

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 5/2013

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Abstract

Purpose

To explore circulating tumor cell (CTCs) counts in different stages of prostate cancer (PC) in association with tumor burden, metastatic pattern and conventional serum biomarkers. Overall survival (OS) analyses were conducted with respect to optimized CTC cutoff levels.

Methods

Circulating tumor cell counts were assessed in healthy controls (n = 15) as well as in locally advanced high risk (LAPC, n = 20), metastatic castration resistant (mCRPC, n = 40) and taxane-refractory (mTRPC, n = 15) PC patients. CTCs were detected using the CellSearch™ System.

Results

In metastatic PC (mPC), CTC counts were significantly increased compared to LAPC (p < 0.001). In LAPC, CTCs were at control level (p = 0.66). Patients with both bone and visceral lesions revealed the highest median CTC count (p = 0.004), whereas patients with sole soft tissue metastases displayed CTC counts comparable to controls (p = 0.16). No correlation was observed between CTC counts and osseous tumor burden assessed by bone lesion count (p = 0.54) or bone scan index (p = 0.81). CTC counts revealed a positive correlation with alkaline phosphatase (p < 0.001) and lactate dehydrogenase (p < 0.001) as well as a negative association with hemoglobin (p = 0.004) and PSA-doubling time (p = 0.01). Kaplan–Meier analyses demonstrated a cohort adjusted cutoff level of 3 CTCs with a shorter OS in case of ≥3 CTCs compared to <3 CTCs (p = 0.001), a cutoff level applicable in mCRPC (p = 0.003) but not in mTRPC patients (p = 0.054).

Conclusions

Circulating tumor cell counts are applicable as a prognostic molecular marker, especially in mCRPC patients harboring bone metastases with or without visceral metastases. For clinical practice, mPC patients with elevated CTC counts in combination with short PSA-DT, high alkaline phosphatase and lactate dehydrogenase levels as well as low hemoglobin levels are at high risk of disease progression and limited OS.

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Titel: Detection of circulating tumor cells in different stages of prostate cancer
verfasst von: Mark Thalgott
Brigitte Rack
Tobias Maurer
Michael Souvatzoglou
Matthias Eiber
Veronika Kreß
Matthias M. Heck
Ulrich Andergassen
Roman Nawroth
Jürgen E. Gschwend
Margitta Retz
Publikationsdatum: 01.05.2013
Verlag: Springer-Verlag
Erschienen in: Journal of Cancer Research and Clinical Oncology / Ausgabe 5/2013
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-013-1377-5

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Detection of circulating tumor cells in different stages of prostate cancer