Frequency and clinical impact of preoperative circulating tumor cells in resectable non-metastatic lung adenocarcinomas. (November 2017)

• Record Type: Journal Article
• Authors: Dandachi, Nadia; Tiran, Verena; Lindenmann, Joerg; Brcic, Luka; Fink-Neuboeck, Nicole; Kashofer, Karl; Absenger, Gudrun; Bezan, Angelika; Cote, Richard J.; Datar, Ram; Balic, Marija
• Is Part Of: Lung cancer. Volume 113(2017)
• Page Start: 152
• Page End: 157
• Publication Date: 2017-11
• Subjects: cfDNA circulating free DNA -- CK pan-cytokeratin -- CT competed tomography -- CTC circulating tumor cells -- DAPI 4 6-diamidino-2-phenylindole -- DFS disease-free survival -- EDTA ethylenediaminetetraacetic acid -- EGFR epidermal growth factor receptor -- EpCAM epithelial cell adhesion molecule -- FFPE formalin-fixed paraffin-embedded -- H&E hematoxylin-eosin -- HR hazard ratio -- KRAS kirsten rat sarcoma viral oncogene homolog -- LVI lympho-vascular invasion -- NA not available -- NACT neoadjuvant chemotherapy -- NGS next generation sequencing -- NMLA non-metastatic lung adenocarcinoma -- NSCLC non-small cell lung cancer -- OS overall survival; Circulating tumor cells -- Non-metastatic -- Preoperative -- Lung cancer -- Recurrence; Lungs -- Cancer -- Periodicals; Lung Neoplasms -- Abstracts; Lung Neoplasms -- Periodicals; Poumons -- Cancer -- Périodiques; Lungs -- Cancer; Periodicals; Electronic journals; Electronic journals; 616.99424
• DOI: 10.1016/j.lungcan.2017.10.003
• Languages: English
• ISSNs: 0169-5002

Abstract

Highlights: CTCs were identified in non-metastatic lung adenocarcinoma patients. NGS-based cfDNA characterization was not informative in our study cohort. CTC positivity was independently associated with disease-free survival. Preoperative CTC detection can identify patients at high risk of disease recurrence. Abstract: Objectives: Despite successful surgery, 30–50% of patients with resectable non-small cell lung cancer develop tumor recurrence within 5 years of surgery. Materials and methods: In this prospective study, we performed CTC enumerations in 40 patients with non-metastatic lung adenocarcinoma (NMLA) using a size-based microfilter. Additionally, cfDNA isolated from plasma was analyzed in 35 out of 40 patients. Results: CTCs were identified in 15 out of 40 patients (37.5%) with a range of 1–44 cells, whereas mutated cfDNA was only detected in 3 out of 35 patients (8.6%). Disease-free survival (DFS) was significantly associated with CTC positivity (log-rank p = 0.025), grading (log-rank p = 0.019), tumor stage (log-rank p = 0.025) and lymph node status (log-rank p = 0.029). Multivariate analysis, including tumor stage and grading, showed that CTC positivity (p = 0.006), grading (0.039) and tumor stage (p = 0.022) were independently associated with DFS. Conclusion: Our study found that microfilter-based CTC enumeration in NMLA patients is an independent predictor of worse DFS. The used NGS-based cfDNA characterization had limited sensitivity to be clinically informative in our study cohort. CTC assessment before surgery can thus identify NMLA patients at high risk of disease recurrence.