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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| Veröffentlicht in: | Hepatology (Baltimore, Md.) Jg. 63; H. 1; S. 148 - 158 |
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| Hauptverfasser: | , , , , , , , , , , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
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United States
Wolters Kluwer Health, Inc
01.01.2016
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| ISSN: | 0270-9139, 1527-3350 |
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| Abstract | 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) |
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| AbstractList | 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. (H
epatology
2016;63:148–158) 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) Circulating tumor cells (CTC) in blood are associated with poor survival of patients with breast, prostate, or colon cancer. We hypothesized that CTC are associated with poor survival of patients with cholangiocarcinoma (CCA). 88 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 CTC in peripheral blood. Associations between CTC, patient and tumor characteristics and survival were examined using the Cox proportional hazards model. Fifteen patients (17%) were positive for CTC ≥2 and 8 patients (9%) for CTC ≥5. CTC were associated with tumor extent. CTC ≥2 (HR, 2.5; 95%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 towards association of CTC ≥5 with shorter survival in patients with non-metastatic CCA (HR 4.3; 95%CI 1.0–13.8; p=0.06). CTC ≥2 (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). 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). 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. UNLABELLEDCirculating 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).CONCLUSIONCTCs 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. 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 greater than or equal to 2 and 8 patients (9%) for CTC greater than or equal to 5. CTCs were associated with tumor extent. CTC greater than or equal to 2 (hazard ratio [HR]: 2.5; 95% confidence interval [CI]: 1.1-5.4; P=0.02) and CTC greater than or equal to 5 (HR, 4.1; 95% CI: 1.4-10.8; P=0.01) were both independent predictors of survival. In subgroup analyses, CTC greater than or equal to 2 (HR, 8.2; 95% CI: 1.8-57.5; P<0.01) and CTC greater than or equal to 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 greater than or equal to 5 with shorter survival in patients with nonmetastatic CCA (HR, 4.3; 95% CI: 1.0-13.8; P=0.06). CTC greater than or equal to 2 (HR, 10.5; 95% CI: 2.2-40.1; P<0.01) and CTC greater than or equal to 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 greater than or equal to 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) |
| Author | Campion, Michael B. Giama, Nasra H. Yang, Ju Dong Zhang, Xiaodan Campion, Victoria L. Venkatesh, Sudhakar K. Halling, Kevin C. Liu, Minetta C. Chaiteerakij, Roongruedee Jen, Jin Ahmed Mohammed, Hager Kipp, Benjamin R. Hu, Chunling Roberts, Lewis R. |
| AuthorAffiliation | 4 Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand 3 Division of Medical Oncology, Mayo Clinic College of Medicine, Rochester, MN, USA 1 Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, USA 2 Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN, USA 5 Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN, USA |
| AuthorAffiliation_xml | – name: 1 Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, USA – name: 4 Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand – name: 2 Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN, USA – name: 3 Division of Medical Oncology, Mayo Clinic College of Medicine, Rochester, MN, USA – name: 5 Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN, USA |
| Author_xml | – sequence: 1 givenname: Ju Dong surname: Yang fullname: Yang, Ju Dong organization: Mayo Clinic College of Medicine – sequence: 2 givenname: Michael B. surname: Campion fullname: Campion, Michael B. organization: Mayo Clinic College of Medicine – sequence: 3 givenname: Minetta C. surname: Liu fullname: Liu, Minetta C. organization: Mayo Clinic College of Medicine – sequence: 4 givenname: Roongruedee surname: Chaiteerakij fullname: Chaiteerakij, Roongruedee organization: Chulalongkorn University and King Chulalongkorn Memorial Hospital – sequence: 5 givenname: Nasra H. surname: Giama fullname: Giama, Nasra H. organization: Mayo Clinic College of Medicine – sequence: 6 givenname: Hager surname: Ahmed Mohammed fullname: Ahmed Mohammed, Hager organization: Mayo Clinic College of Medicine – sequence: 7 givenname: Xiaodan surname: Zhang fullname: Zhang, Xiaodan organization: Mayo Clinic College of Medicine – sequence: 8 givenname: Chunling surname: Hu fullname: Hu, Chunling organization: Mayo Clinic College of Medicine – sequence: 9 givenname: Victoria L. surname: Campion fullname: Campion, Victoria L. organization: Mayo Clinic College of Medicine – sequence: 10 givenname: Jin surname: Jen fullname: Jen, Jin organization: Mayo Clinic College of Medicine – sequence: 11 givenname: Sudhakar K. surname: Venkatesh fullname: Venkatesh, Sudhakar K. organization: Mayo Clinic College of Medicine – sequence: 12 givenname: Kevin C. surname: Halling fullname: Halling, Kevin C. organization: Mayo Clinic College of Medicine – sequence: 13 givenname: Benjamin R. surname: Kipp fullname: Kipp, Benjamin R. organization: Mayo Clinic College of Medicine – sequence: 14 givenname: Lewis R. surname: Roberts fullname: Roberts, Lewis R. organization: Mayo Clinic College of Medicine |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26096702$$D View this record in MEDLINE/PubMed |
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| Copyright | 2015 by the American Association for the Study of Liver Diseases 2015 by the American Association for the Study of Liver Diseases. 2016 by the American Association for the Study of Liver Diseases |
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| Notes | 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. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 contributed equally to the study. |
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| SubjectTerms | 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 |
| Title | Circulating tumor cells are associated with poor overall survival in patients with cholangiocarcinoma |
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