Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Frankfurt, Frankfurt, Germany.
Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Eur Urol Focus. 2021 Jan;7(1):55-62. doi: 10.1016/j.euf.2019.05.008. Epub 2019 Jun 6.
The prognostic value of circulating tumor cells (CTCs) in patients with hormone-naïve oligometastatic prostate cancer (HNoMPC) undergoing cytoreductive radical prostatectomy (CRP) is unknown.
To determine the pre- and postoperative prognostic value of CTC enumeration in patients undergoing CRP.
DESIGN, SETTING, AND PARTICIPANTS: Thirty-three patients with HNoMPC from the prospective, single-arm ProMPT trial who underwent CRP between 2014 and 2015 at the Martini-Klinik were evaluated. Follow-up visits for all patients were conducted every 6 mo up to 36 mo after CRP and included serial detection of CTCs in 7.5 ml blood samples using the CellSearch system.
CRP.
CTC enumerations before and after CRP, and their prognostic value on metastatic castration-resistant prostate cancer-free survival and overall survival (OS) were analyzed using Kaplan-Meier plots and univariable Cox-regression analysis.
Sixteen patients (48.5%) had positive CTCs prior to CRP. A CTC count of ≥2 before or 6 mo after CRP was a prognostic factor for worse oncologic outcome. Compared with other biomarkers (prostate-specific antigen, lactate dehydrogenase, and bone-specific alkaline phosphatase), the prognostic value of CTCs was highest using Harrell's C for OS (0.69), while the highest C-index could be achieved for a combination of conventional markers and CTC count (0.74). After progression to metastatic castration-resistant prostate cancer, CTC enumeration of ≥5 was prognostic for OS. The main limitation is the small sample size.
CTC enumeration contributes to prognostic information, which might help select HNoMPC patients who might benefit most from CRP.
In this report, we looked at the value of circulating tumor cell (CTC) determination in patients undergoing radical prostatectomy for oligometastatic prostate cancer. We could show that the number of CTCs was a prognostic factor at all analyzed time points and was more closely associated with prognosis than other biomarkers commonly used in daily clinical practice.
在接受去势治疗的寡转移前列腺癌（HNoMPC）患者中，循环肿瘤细胞（CTC）的预后价值在接受细胞减灭性根治性前列腺切除术（CRP）的患者中尚不清楚。
确定 CRP 术前和术后 CTC 计数的预后价值。
设计、地点和参与者：对 2014 年至 2015 年在马蒂尼诊所接受 CRP 的前瞻性单臂 ProMPT 试验的 33 例 HNoMPC 患者进行评估。所有患者的随访时间为 CRP 后 36 个月内每 6 个月进行一次，包括使用 CellSearch 系统在 7.5ml 血液样本中连续检测 CTC。
CRP。
使用 Kaplan-Meier 图和单变量 Cox 回归分析分析 CRP 前后的 CTC 计数及其对转移性去势抵抗性前列腺癌无复发生存和总生存（OS）的预后价值。
16 例患者（48.5%）在 CRP 前 CTC 阳性。CRP 前或 6 个月后 CTC 计数≥2 是肿瘤预后不良的预后因素。与其他生物标志物（前列腺特异性抗原、乳酸脱氢酶和骨特异性碱性磷酸酶）相比，CTC 对 OS 的预后价值最高（Harrell's C 为 0.69），而常规标志物和 CTC 计数的组合可获得最高的 C 指数（0.74）。转移性去势抵抗性前列腺癌进展后，CTC 计数≥5 对 OS 具有预后意义。主要的局限性是样本量小。
CTC 计数有助于提供预后信息，这可能有助于选择最有可能从 CRP 中获益的 HNoMPC 患者。
在本报告中，我们研究了在接受寡转移前列腺癌根治性前列腺切除术的患者中测定循环肿瘤细胞（CTC）的价值。我们可以表明，在所有分析的时间点，CTC 数量都是一个预后因素，与其他在日常临床实践中常用的生物标志物相比，与预后的相关性更密切。
