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Detection and Clinical Significance of Circulating Tumor Cells in Patients Undergoing Radical Cystectomy for Urothelial Bladder Cancer
- Publication Year :
- 2017
-
Abstract
- Estimation of prognosis is patients undergoing radical cystectomy is often unreliable, as occult disease remains undetected by conventional diagnostic tools. The purpose of this study was to evaluate the feasibility and the clinical significance of a polymerase chain reaction assay to detect cytokeratin 7 (CK7) mRNA expression in peripheral blood cells of patients undergoing radical cystectomy for clinically nonmetastatic bladder cancer.From 2005 to 2009, 59 patients undergoing radical cystectomy and pelvic lymph node dissection were prospectively investigated. Peripheral blood was collected prior to surgery, and a nested polymerase chain reaction assay was developed to identify patients with circulating cells expressing CK7 mRNA. Preoperative, histopathologic data and clinical outcome were compared with CK7 findings.CK7 expression was detected in 23 (38.9%) of 59 patients and correlated to T stage and lymph node status. After a median follow-up of 42 months, 29 patients experienced a recurrence, whereas 36 died. The presence of CK7-positive cells was significantly associated with an increased risk for recurrence and decreased survival as compared with patients who were CK7-negative (P .001 and P .001, respectively; hazard ratios of 8.77 and 5.2 for recurrence and overall death, respectively). The detection of CK7-positive cells was an independent predictor of recurrence and death in a multivariable analysis.The detection of CK7 mRNA in the circulating cells of patients undergoing radical cystectomy for urothelial cancer identifies those with significantly increased risk of cancer recurrence and death.
- Subjects :
- Male
0301 basic medicine
medicine.medical_specialty
Urology
medicine.medical_treatment
Cystectomy
Pelvis
Settore MED/24 - Urologia
03 medical and health sciences
Cytokeratin
0302 clinical medicine
Circulating tumor cell
Biomarkers, Tumor
medicine
Humans
Clinical significance
Prospective Studies
Lymph node
Neoplasm Staging
Carcinoma, Transitional Cell
Bladder cancer
business.industry
Keratin-7
Neoplastic Cells, Circulating
Prognosis
medicine.disease
Survival Analysis
030104 developmental biology
medicine.anatomical_structure
Urinary Bladder Neoplasms
Oncology
030220 oncology & carcinogenesis
Feasibility Studies
Lymph Node Excision
T-stage
Female
business
Nested polymerase chain reaction
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....c82767662297bc85be7ff1f005470cb3