Disseminated tumor cells in bone marrow of patients with endometrial and cervical cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5598-5598
Author(s):  
Florin-Andrei Taran ◽  
Markus Wallwiener ◽  
Andreas D. Hartkopf ◽  
Christina Walter ◽  
Sara Brucker ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Bone Marrow ◽  
Clinical Outcome ◽  
Tumor Cells ◽  
Vulvar Cancer ◽  
Gynecologic Cancer ◽  
Prognostic Significance ◽  
Disseminated Tumor Cells ◽  
Gynecology And Obstetrics ◽  
Lymphangiosis Carcinomatosa

5598 Background: The presence of disseminated tumor cells (DTC) in the bone marrow (BM) of breast cancer patients is associated with poor prognosis. Several studies demonstrated that tumor cell dissemination may occur in gynecologic cancer and affect clinical outcome. The aim of our study was to evaluate the incidence of DTC and to assess their prognostic significance in patients with gynecologic malignancies. Methods: Bone marrow aspirates from 623 patients with primary endometrial (331), cervical (228), and vulvar cancer (64) undergoing surgery at the Department of Gynecology and Obstetrics, University Hospital, Tuebingen, Germany between November 2001 and May 2012, were included into the study. Disseminated tumor cells were identified by immunocytochemistry using the pancytokeratin antibody A45B/B3 and by cytomorphology. Results: Disseminated tumor cells were detected in 18% of BM aspirates from patients with gynecological malignancies. Incidences of DTC in endometrial, cervical, and vulvar cancer were 21%, 16% and 16%, respectively. The presence of DTC was associated with a lower tumor grade in endometrial cancer For patients with vulvar cancer, no correlation with established clinicopathological factors was observed. In case of cervical cancer, BM positivity was correlated with International Federation of Gynecology and Obstetrics stage, nodal involvement and the presence of lymphangiosis carcinomatosa. For all analyzed tumor entities, no association between BM status and clinical outcome could be observed. Conclusions: Disseminated tumor cells are a common phenomenon in solid tumors. However, only in cervical cancer DTC postivity was associated with advanced disease. The consequences for DTC positive patients have to be determined.

Prognostic Significance of Disseminated Tumor Cells in the Bone Marrow of Prostate Cancer Patients Treated With Neoadjuvant Hormone Treatment

2008 ◽  
Vol 26 (30) ◽  
pp. 4928-4933 ◽  
Author(s):  
Jens Köllermann ◽  
Steffen Weikert ◽  
Martin Schostak ◽  
Carsten Kempkensteffen ◽  
Klaus Kleinschmidt ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Marrow ◽  
Radical Prostatectomy ◽  
Hormone Therapy ◽  
Cancer Patients ◽  
Tumor Cells ◽  
Prognostic Significance ◽  
Specific Antigen ◽  
Disseminated Tumor Cells ◽  
Significant Prognostic Factor

Purpose To explore whether the presence of occult disseminated tumor cells (DTCs) in the bone marrow before neoadjuvant hormone therapy influences the prognosis of patients with organ confined prostate cancer treated by radical prostatectomy. Patients and Methods Pretreatment bone marrow aspirates from 193 cT (1-4) pN0M0 prostate cancer patients submitted to neoadjuvant hormone therapy (mean, 8 months) followed by radical prostatectomy were immunohistochemically evaluated by anticytokeratin antibody A45-B/B3 previously validated for the detection of DTCs. Bone marrow status was compared with established clinical and histopathologic risk parameters. Patients’ outcome was evaluated using prostate-specific antigen (PSA) blood serum measurements as surrogate marker for recurrence over a median follow-up of 44 months. Results DTCs were detected in 44.6% of patients. Bone marrow status neither correlated with tumor grade and stage, nor with the pretreatment PSA risk category (all P values > .05). In the univariate Kaplan-Meier analysis, the presence of DTCs was a significant prognostic factor with respect to poor PSA progression-free survival (log-rank test P = .0035). Using a multivariable piecewise Cox regression model, the presence of DTCs was an independent predictor of PSA relapse (relative risk 1.82; P = .014). Conclusion The presence of DTCs in the bone marrow of patients with prostate cancer before neoadjuvant hormone therapy and subsequent surgery represents an independent prognostic parameter, suggesting that DTCs may contribute to the failure of current neoadjuvant hormone therapy regimens.

scholarly journals Presence of disseminated tumor cells in bone marrow correlates with tumor stage and nodal involvement in cervical cancer patients

2013 ◽  
Vol 134 (4) ◽  
pp. 925-931 ◽  
Author(s):  
Tanja Fehm ◽  
Malgorzata Banys ◽  
Brigitte Rack ◽  
Bernadette Jäger ◽  
Andreas Hartkopf ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Bone Marrow ◽  
Cancer Patients ◽  
Tumor Cells ◽  
Disseminated Tumor Cells ◽  
Tumor Stage ◽  
Nodal Involvement

scholarly journals Pooled Analysis of the Prognostic Relevance of Disseminated Tumor Cells in the Bone Marrow of Patients With Ovarian Cancer

2013 ◽  
Vol 23 (5) ◽  
pp. 839-845 ◽  
Author(s):  
Tanja Fehm ◽  
Malgorzata Banys ◽  
Brigitte Rack ◽  
Wolfgang Janni ◽  
Christian Marth ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Bone Marrow ◽  
Overall Survival ◽  
Confidence Interval ◽  
Tumor Cell ◽  
Tumor Cells ◽  
Disseminated Tumor Cells ◽  
International Federation ◽  
Gynecology And Obstetrics ◽  
Resection Status

ObjectiveDetection of disseminated tumor cells (DTCs) in the bone marrow (BM) of patients with breast cancer is associated with poor outcomes. Recent studies demonstrated that DTCs may serve as a prognostic factor in ovarian cancer. The aim of this 3-center study was to evaluate the impact of BM status on survival in a large cohort of patients with ovarian cancer.Materials and MethodsFour hundred ninety-five patients with primary ovarian cancer were included in this 3-center prospective study. Bone marrow aspirates were collected intraoperatively from the iliac crest. Disseminated tumor cells were identified by antibody staining and by cytomorphology. Clinical outcome was correlated with the presence of DTCs.ResultsDisseminated tumor cells were detected in 27% of all BM aspirates. The number of cytokeratin-positive cells ranged from 1 to 42 per 2 × 106 mononuclear cells. Disseminated tumor cell status did correlate with histologic subtype but not with any of the other established clinicopathologic factors. The overall survival was significantly shorter among DTC-positive patients compared to DTC-negative patients (51 months; 95% confidence interval, 37–65 months vs 33 months; 95% confidence interval, 23–43 months; P = 0.023). In the multivariate analysis, BM status, International Federation of Gynecology and Obstetrics stage, nodal status, resection status, and age were independent predictors of reduced overall survival, whereas only BM status, International Federation of Gynecology and Obstetrics stage, and resection status independently predicted progression-free survival.ConclusionsTumor cell dissemination into the BM is a common phenomenon in ovarian cancer. Disseminated tumor cell detection has the potential to become an important biomarker for prognostication and disease monitoring in patients with ovarian cancer.

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