| Autor: |
Hugenschmidt H; Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway.; Department of Transplantation Surgery, Oslo University Hospital, 0424 Oslo, Norway.; Department of Gastrointestinal Surgery, Oslo University Hospital, 0424 Oslo, Norway., Labori KJ; Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway.; Department of Gastrointestinal Surgery, Oslo University Hospital, 0424 Oslo, Norway., Borgen E; Department of Pathology, Oslo University Hospital, 0424 Oslo, Norway., Brunborg C; Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, 0424 Oslo, Norway., Schirmer CB; Department of Pathology, Oslo University Hospital, 0424 Oslo, Norway., Seeberg LT; Department of Gastrointestinal Surgery, Oslo University Hospital, 0424 Oslo, Norway.; Department of Gastrointestinal Surgery, Vestfold Hospital Trust, 3103 Tønsberg, Norway., Naume B; Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway.; Department of Oncology, Oslo University Hospital, 0424 Oslo, Norway., Wiedswang G; Department of Gastrointestinal Surgery, Oslo University Hospital, 0424 Oslo, Norway. |
| Abstrakt: |
In patients with presumed pancreatic ductal adenocarcinoma (PDAC), biomarkers that may open for personalised, risk-adapted treatment are lacking. The study analysed the impact of CTCs-presence on the patterns of recurrence and survival in 98 patients resected for PDAC with 5-10 years of follow-up. Preoperative samples were analysed by the CellSearch ® system for EpCAM+/DAPI+/CK+/CD45-CTCs. CTCs were detected in 7 of the 98 patients. CTCs predicted a significantly shorter median disease-free survival (DFS) of 3.3 vs. 9.2 months and a median cancer specific survival (CSS)of 6.3 vs. 18.5 months. Relapse status was confirmed by imaging for 87 patients. Of these, 58 patients developed distant metastases (DM) and 29 developed isolated local recurrence (ILR) as the first sign of cancer relapse. All patients with CTCs experienced DM. pN-status and histological grade >2 were other independent risk factors for DM, but only CTCs predicted significantly shorter cancer-specific, disease-free and post-recurrence survival. Preoperative parameters did not affect clinical outcome. We conclude that CTC presence in resected PDAC patients predicted early distant metastasis and impaired survival. Preoperative CTCs alone or in combination with histopathological factors may guide initial treatment decisions in patients with resectable PDAC in the future. |
