Circulating tumor cells are associated with poor overall survival in patients with cholangiocarcinoma

Circulating tumor cells (CTCs) in blood are associated with poor survival of patients with breast, prostate, or colon cancer. We hypothesized that CTCs are associated with poor survival of patients with cholangiocarcinoma (CCA). Eighty‐eight patients with CCA were prospectively enrolled at Mayo Clin...

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Published in:Hepatology (Baltimore, Md.) Vol. 63; no. 1; pp. 148 - 158
Main Authors: Yang, Ju Dong, Campion, Michael B., Liu, Minetta C., Chaiteerakij, Roongruedee, Giama, Nasra H., Ahmed Mohammed, Hager, Zhang, Xiaodan, Hu, Chunling, Campion, Victoria L., Jen, Jin, Venkatesh, Sudhakar K., Halling, Kevin C., Kipp, Benjamin R., Roberts, Lewis R.
Format: Journal Article
Language:English
Published: United States Wolters Kluwer Health, Inc 01.01.2016
Subjects:
Bile Duct Neoplasms - blood
Bile Duct Neoplasms - mortality
Bile Duct Neoplasms - pathology
Breast cancer
Cholangiocarcinoma
Cholangiocarcinoma - blood
Cholangiocarcinoma - mortality
Cholangiocarcinoma - secondary
Colon cancer
Colorectal cancer
Confidence intervals
Female
Hepatology
Humans
Male
Metastases
Middle Aged
Mortality
Neoplastic Cells, Circulating
Peripheral blood
Proportional Hazards Models
Prospective Studies
Prostate cancer
Survival
Survival Rate
Tumor cells
ISSN:0270-9139, 1527-3350
Online Access:Get full text
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Summary:Circulating tumor cells (CTCs) in blood are associated with poor survival of patients with breast, prostate, or colon cancer. We hypothesized that CTCs are associated with poor survival of patients with cholangiocarcinoma (CCA). Eighty‐eight patients with CCA were prospectively enrolled at Mayo Clinic Rochester between June 2010 and September 2014. The CellSearch system by Veridex was used for detection of CTCs in peripheral blood. Associations between CTC, patient and tumor characteristics, and survival were examined using the Cox's proportional hazards model. Fifteen patients (17%) were positive for CTC ≥2 and 8 patients (9%) for CTC ≥5. CTCs were associated with tumor extent. CTC ≥2 (hazard ratio [HR]: 2.5; 95% confidence interval [CI]: 1.1‐5.4; P = 0.02) and CTC ≥5 (HR, 4.1; 95% CI: 1.4‐10.8; P = 0.01) were both independent predictors of survival. In subgroup analyses, CTC ≥2 (HR, 8.2; 95% CI: 1.8‐57.5; P < 0.01) and CTC ≥5 (HR, 7.7; 95% CI: 1.4‐42.9; P = 0.02) were both associated with shorter survival among patients with metastasis. There was a trend toward association of CTC ≥5 with shorter survival in patients with nonmetastatic CCA (HR, 4.3; 95% CI: 1.0‐13.8; P = 0.06). CTC ≥2 (HR, 10.5; 95% CI: 2.2‐40.1; P < 0.01) and CTC ≥5 (HR, 10.2; 95% CI: 1.5‐42.3; P = 0.02) were both associated with shorter survival among patients with perihilar/distal CCA. CTC ≥5 was associated with shorter survival of patients with intrahepatic CCA (HR, 4.2; 95% CI: 1.1‐14.1; P = 0.04). Conclusion: CTCs were associated with more‐aggressive tumor characteristics and independently associated with survival in patients with CCA. Assessment of CTCs may be useful for identifying CCA patients at risk of early mortality. (Hepatology 2016;63:148–158)
Bibliography:Potential conflict of interest: Minetta C. Liu receives research funding from Veridex/Janssen; all funds are provided to the institution with no personal compensation.
This publication was supported by grant no. T32 DK07198 from the National Institute of Diabetes and Digestive and Kidney Diseases (to J.Y.) and CA100882, CA128633, and CA165076 from the National Cancer Institute (NCI) and The Cholangiocarcinoma Foundation (to L.R.R.). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.
See Editorial on Page 23
These authors contributed equally to the study.
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contributed equally to the study.
ISSN:0270-9139
1527-3350
DOI:10.1002/hep.27944