Abstract
Purpose: The aim of the study was to evaluate the association between clinicopathological and prognostic significance and circulating tumor cells (CTCs) in patients with head and neck cancer. Methods: We searched PubMed, MEDLINE, BioMed, and EMbase databases for studies that assessed the association between clinicopathological and prognostic significance and CTCs in patients with head and neck cancer. Studies obtained from search strategy were screened using pre-specified criteria, and necessary data were retrieved for meta-analysis. Results: Seventeen studies with 816 patients were eligible for combined analysis. Presence of CTCs in peripheral blood was significantly associated with N stage (OR 0.50, 95%CI [0.30, 0.81], n = 10, P = 0.005). Patients in the high-CTC group were significantly associated with poorer disease-free survival (DFS; HR = 1.73, 95%CI [1.01 - 2.96], P = 0.050) and poorer overall survival (OS; HR = 2.53, 95%CI [1.37 - 4.69] P = 0.003). Further analyses indicated strong prognostic powers of CTCs in non-RT-PCR group and pre-treatment group. Conclusion: Our meta-analysis indicates that presence of CTCs is associated with higher N stage and poorer prognosis in patients with head and neck cancer. The potential for further clinical application may be needed for further investigation.Purpose: The aim of the study was to evaluate the association between clinicopathological and prognostic significance and circulating tumor cells (CTCs) in patients with head and neck cancer. Methods: We searched PubMed, MEDLINE, BioMed, and EMbase databases for studies that assessed the association between clinicopathological and prognostic significance and CTCs in patients with head and neck cancer. Studies obtained from search strategy were screened using pre-specified criteria, and necessary data were retrieved for meta-analysis. Results: Seventeen studies with 816 patients were eligible for combined analysis. Presence of CTCs in peripheral blood was significantly associated with N stage (OR 0.50, 95%CI [0.30, 0.81], n = 10, P = 0.005). Patients in the high-CTC group were significantly associated with poorer disease-free survival (DFS; HR = 1.73, 95%CI [1.01 - 2.96], P = 0.050) and poorer overall survival (OS; HR = 2.53, 95%CI [1.37 - 4.69] P = 0.003). Further analyses indicated strong prognostic powers of CTCs in non-RT-PCR group and pre-treatment group. Conclusion: Our meta-analysis indicates that presence of CTCs is associated with higher N stage and poorer prognosis in patients with head and neck cancer. The potential for further clinical application may be needed for further investigation.
Highlights
Cancer of the head and neck is the 6th most common cancer worldwide contributing 600,000 new cases of cancer every year and more than 95% of those cases are squamous cell carcinomas [1]
Recent researches have revealed that circulating tumor cells (CTCs) in peripheral blood may serve as a potential biomarker
Our research suggested that positive CTCs detected by RT-PCR array may be associated with advanced T stage and N stage whereas Non-RT-PCR methods, mainly Cell Search system seemed to be superior to RT-PCR array in predicting disease-free survival (DFS) and overall survival (OS)
Summary
Cancer of the head and neck is the 6th most common cancer worldwide contributing 600,000 new cases of cancer every year and more than 95% of those cases are squamous cell carcinomas [1]. Recent advances in diagnosis and cancer therapy have improved 5-year survival rates by 10% in patients with H&N cancer, locoregional recurrence and distant metastasis are the main causes of treatment failure which occurs in 30% - 40% of the patients. Recent researches have revealed that circulating tumor cells (CTCs) in peripheral blood may serve as a potential biomarker. CTCs, which were first reported by Ashworth in 1869 [2], are tumor cells circulating in blood vessels and sheltered subsets with metastasis-initiating ability [3]. There still remains controversial regarding clinical significance of CTCs in patients with H&N cancer
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