Abstract
BackgroundDisseminated tumor cells (DTCs) and circulating tumor cells (CTCs) have been postulated to seed metastases and contribute to poorer patient outcomes in many types of solid cancer. To date, no systematic reviews have examined the role of both DTCs and CTCs in pancreatic cancer. We aimed to determine the prognostic value of DTCs/CTCs in pancreatic cancer using a systematic review and meta-analysis.Materials and MethodsA comprehensive literature search identified studies examining DTCs and CTCs in the bone marrow and blood of pancreatic cancer patients at diagnosis with follow-up to determine disease-free/progression-free survival (DFS/PFS) and overall survival (OS). Statistical analyses were performed to determine the hazard ratio (HR) of DTCs/CTCs on DFS/PFS and OS.ResultsThe literature search identified 16 articles meeting the inclusion criteria. The meta-analysis demonstrated statistically significant HR differences in DFS/PFS (HR = 1.93, 95% CI 1.19–3.11, P = 0.007) and OS (HR = 1.84, 95% CI 1.37–2.45, P =< 0.0001), indicating patients with detectable DTCs/CTCs at diagnosis have worse prognoses. Subgroup analyses suggested CTCs in the peripheral blood (HR =2.03) were more indicative of poor OS prognosis than DTCs in the bone marrow (HR = 1.91), although the difference between these was not statistically significant. Positivity of the CellSearch detection method for DTC/CTC had the highest correlation with decreased OS (HR = 2.79) while immunodetection (HR = 1.91) and RT-PCR (HR = 1.25) were less effective in determining prognosis.ConclusionThe detection of DTCs/CTCs at diagnosis is associated with poorer DFS/PFS and OS in pancreatic cancer.
Highlights
Pancreatic cancer (PC) is the fourth most common cause of cancer-related death in the United States, resulting in an estimated 41,000 deaths each year [1]
The meta-analysis demonstrated statistically significant hazard ratio (HR) differences in disease-free survival (DFS)/progression-free survival (PFS) (HR = 1.93, 95% confidence interval (CI) 1.19–3.11, P = 0.007) and overall survival (OS) (HR = 1.84, 95% CI 1.37–2.45, P =< 0.0001), indicating patients with detectable Disseminated tumor cells (DTCs)/circulating tumor cells (CTCs) at diagnosis have worse prognoses
Positivity of the CellSearch detection method for DTC/CTC had the highest correlation with decreased OS (HR = 2.79) while immunodetection (HR = 1.91) and RT-PCR (HR = 1.25) were less effective in determining prognosis
Summary
Pancreatic cancer (PC) is the fourth most common cause of cancer-related death in the United States, resulting in an estimated 41,000 deaths each year [1]. PC is the seventh most common cause of cancer-related death, resulting in the deaths of 173,800 males and 156,600 females annually [2]. Circulating tumor cells (CTCs), tumor cells shed from the primary tumor circulating through the vascular system, have been proposed as a potential biological marker for early detection, prognosis, treatment selection and monitoring disease progression in PC [3,4,5,6]. Disseminated tumor cells (DTCs) and circulating tumor cells (CTCs) have been postulated to seed metastases and contribute to poorer patient outcomes in many types of solid cancer. We aimed to determine the prognostic value of DTCs/CTCs in pancreatic cancer using a systematic review and meta-analysis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
