3:36 PM Abstract No. 275 ■ FEATURED ABSTRACT EpCAM-positive circulating tumor cells independently predict poor outcomes of transcatheter arterial chemoembolization in patients with unresectable hepatocellular carcinoma

Abstract

To assess the role of epithelial cell adhesion molecule (EpCAM)-positive circulating tumor cell (CTC) count in predicting outcomes of transcatheter arterial chemoembolization (TACE) in patients with unresectable hepatocellular carcinoma (HCC). EpCAM-positive CTC counts were prospectively determined in peripheral blood of 97 patients with unresectable HCC treated with TACE, using CellSearch system. The impact of each cutoff point (each CTC value) on overall survival (OS) was evaluated by the univariate Cox regression analysis. Based on the hazard ratio (HR), the patients were divided into 3 groups: low risk (CTC = 0 and 1), moderate risk (CTC = 2-5) and high risk (CTC≥6) groups. Cox proportional hazards model was used to assess the correlation of CTC counts with outcomes. Eighty-nine patients were enrolled in this study according to patient-selection criteria. The low risk group was used as the control group for univariate Cox analysis. Mortality risk in the high risk and moderate risk groups was 4.164 (95% Confidence Interval [CI], 2.042-8.492, P = 0.000) and 1.695 (95%CI, 0.883-3.253, P = 0.113) times higher, respectively, than that in the low-risk group. On multivariate Cox regression analysis, CTC count was found to be an independent predictor of OS (P = 0.049) and progression-free survival (PFS) (P = 0.007) in patients treated with TACE. After adjustment for confounding factors, the mortality risk in the high risk and moderate risk groups was 2.819 times (95%CI, 1.218-6.526, P = 0.016) and 1.301 times (95%CI, 0.630-2.685, P = 0.477) higher than that in the low risk group. EpCAM-positive CTC count can independently predict poor outcomes of TACE in patients with unresectable HCC.