876 PREOPERATIVE DETECTION OF A SINGLE CIRCULATING TUMOUR CELL IS INDEPENDENTLY ASSOCIATED WITH INFERIOR OUTCOME IN PATIENTS WITH UROTHELIAL CARCINOMA OF THE BLADDER (2012)

You have accessJournal of UrologyBladder Cancer: Basic Research II1 Apr 2012876 PREOPERATIVE DETECTION OF A SINGLE CIRCULATING TUMOUR CELL IS INDEPENDENTLY ASSOCIATED WITH INFERIOR OUTCOME IN PATIENTS WITH UROTHELIAL CARCINOMA OF THE BLADDER Michael Rink, Armin Soave, Felix K. Chun, Roland Dahlem, Jens Hansen, Sarah Minner, Luis A. Kluth, Martin G. Friedrich, Hans Heinzer, Roman Heuer, Sascha A. Ahyai, Oliver Engel, Christian Eichelberg, Shahrokh F. Shariat, Klaus Pantel, Margit Fisch, and Sabine Riethdorf Michael RinkMichael Rink New York, NY More articles by this author , Armin SoaveArmin Soave Hamburg, Germany More articles by this author , Felix K. ChunFelix K. Chun Hamburg, Germany More articles by this author , Roland DahlemRoland Dahlem Hamburg, Germany More articles by this author , Jens HansenJens Hansen Hamburg, Germany More articles by this author , Sarah MinnerSarah Minner Hamburg, Germany More articles by this author , Luis A. KluthLuis A. Kluth Hamburg, Germany More articles by this author , Martin G. FriedrichMartin G. Friedrich Krefeld, Germany More articles by this author , Hans HeinzerHans Heinzer Hamburg, Germany More articles by this author , Roman HeuerRoman Heuer Hamburg, Germany More articles by this author , Sascha A. AhyaiSascha A. Ahyai Hamburg, Germany More articles by this author , Oliver EngelOliver Engel Hamburg, Germany More articles by this author , Christian EichelbergChristian Eichelberg Hamburg, Germany More articles by this author , Shahrokh F. ShariatShahrokh F. Shariat New York, NY More articles by this author , Klaus PantelKlaus Pantel Hamburg, Germany More articles by this author , Margit FischMargit Fisch Hamburg, Germany More articles by this author , and Sabine RiethdorfSabine Riethdorf Hamburg, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.971AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Circulating tumour cells (CTC) are frequently detectable in the peripheral blood of patients with urothelial cancer of the bladder (UCB) prior to radical cystectomy (RC). We hypothesize that CTC can predict advanced stages, nodal status and disease outcome after radical cystectomy and therefore represent an optimal biomarker for treatment decision making and patient counseling. METHODS Between July 2007 and August 2011 blood samples of 120 consecutive, clinically non-metastatic UCB patients scheduled for RC were prospectively investigated for CTC. Preoperatively collected blood samples (7.5 ml) were analysed for CTC using the CellSearch® system (Veridex, USA). Uni- and multivariable models evaluated the association of CTC status (positive vs. negative) and number of CTC with clinical and nodal stage and disease outcome. RESULTS CTC were detectable in 30 of 120 patients (25%) with an average number of 5.7±18.3 CTC (range:1-100; median:1). Eighteen patients (60.0%) had 1 CTC/7.5mL, 8 patients (26.7%) had 2-5 CTC and 4 patients (13.3%) had >5 CTC, respectively. CTC status was not associated with tumour stage, grade, lymph node metastases, lymphvascular invasion or margin status after RC. Moreover, increasing numbers of CTC were not associated with higher stages or increasing numbers of lymph node metastases. However, at a median follow-up of 18 months (range:1-48 months) CTC detection prior to RC was an independent prognostic factor for disease recurrence (Hazard ratio(HR)=4.9, 95% confidence interval (CI) 2.1–11.7, p<0.001) and cancer-specific death (HR=4.9, 95%CI 1.7-13.6, p=0.002). Disease recurrence and cancer-related death were not associated with the number of detected CTC. CONCLUSIONS Although CTC can not predict pathological or nodal stage, they are associated with inferior disease outcomes. Detection of even 1 CTC/7.5 mL blood in UCB patients prior to RC is an independent predictor for disease recurrence and cancer-related death. These findings are very important for future investigations, as they are in contradiction to theories supporting a cut-off value of 5 or more CTC needed for accurate outcome prediction. Therefore, CTC may represent a feasible biomarker for monitoring response to neoadjuvant and adjuvant chemotherapy. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e356-e357 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Rink New York, NY More articles by this author Armin Soave Hamburg, Germany More articles by this author Felix K. Chun Hamburg, Germany More articles by this author Roland Dahlem Hamburg, Germany More articles by this author Jens Hansen Hamburg, Germany More articles by this author Sarah Minner Hamburg, Germany More articles by this author Luis A. Kluth Hamburg, Germany More articles by this author Martin G. Friedrich Krefeld, Germany More articles by this author Hans Heinzer Hamburg, Germany More articles by this author Roman Heuer Hamburg, Germany More articles by this author Sascha A. Ahyai Hamburg, Germany More articles by this author Oliver Engel Hamburg, Germany More articles by this author Christian Eichelberg Hamburg, Germany More articles by this author Shahrokh F. Shariat New York, NY More articles by this author Klaus Pantel Hamburg, Germany More articles by this author Margit Fisch Hamburg, Germany More articles by this author Sabine Riethdorf Hamburg, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...