e14556 Background: Pancreatic carcinoma is one of the most aggressive malignancies with a poor prognosis. Assessment of occult tumor cells could prevent aggressive surgery in patients with metastatic spread. The aim of this study was to investigate the prognostic significance of occult tumor cells in peritoneal lavage of patients with pancreatic carcinoma. Methods: This was a prospective study to assess the presence of occult tumor cells in peritoneal lavage of 96 pancreatic carcinoma patients at the time of surgery using real-time RT-PCR for carcinoembryonic antigen (CEA), epidermal growth factor receptor 1 (EGFR1) and human telomerase (hTERT). Gene expression of tested markers was correlated with clinical/pathological characteristics using Kruskal-Wallis Anova and Mann-Whitney tests. Kaplan-Meier methods and Gehan-Wilcoxon tests were used for overall survival analyses. Results: Overall, 65 of 96 (69.9%) pancreatic carcinoma patients died, the overall survival median was 10.3 months. A significant association between CEA expression in peritoneal lavage and the clinical stage was found (p<0.03). In addition, patients with high grade tumors had significantly higher expression of EGFR in peritoneal lavage compared to patients with low grade tumors (p<0.04). The patients with the presence of occult cancer cells detected in the peritoneal lavage using CEA and/or EGFR had significantly shorter overall survival (p<0.001; HR=2.14 [95% CI: 1.30-3.55]) with overall survival median 6.8 months. Conclusions: These data demonstrate that the presence of occult tumor cells in peritoneal lavage is a negative prognostic factor in pancreatic carcinoma patients. Occult tumor cells detection using PCR based methods can identify patients with advanced disease for whom radical surgery is of no benefit. Prospective studies should confirm usefulness of this method for the selection of patients for radical surgery. Acknowledgements: Supported by grants IGA MZ NS 9937‑4, MPOTIP FR-TI1/525, IGA UP LF_2011_018 and CZ.1.05/2.1.00/01.0030.
OCCULT TUMOR CELLS IN LYMPH NODES AS A PREDICTOR FOR TUMOR RELAPSE IN PANCREATIC CANCER