Abstract
1033 Background: The prognostic significance of CTC in primary breast cancer has been demonstrated for 2,026 patients (pts) of the German SUCCESS-study (Rack et al, in press). In this analysis the prognostic relevance of CTC in peripheral blood at primary diagnosis in a different cohort of pts of the same trial regarding disease free (DFS) and overall survival (OAS) was investigated. Methods: As part of the translational research project we analyzed 23ml of peripheral blood from 1247 breast cancer pts before adjuvant taxane based chemotherapy. Cells were separated by Oncoquick (greiner bio-one, Frickenhausen, Germany) followed by labelling of epithelial cells with the anti-cytokeratine-antibody A45-B/B3 (Micromet, Munich, Germany) directed against cytokeratines 8, 18 and 19 and immunohistochemically staining with neu-fuchsin. All cytospins were screened by two independent persons. Results: In 21.1% of all pts (n=263) at least 1 CTC was detected (median 1.8, range 1−28) while 78.9% of the pts (n=984) were negative for CTC before adjuvant chemotherapy. 38.3% of the pts had a pT1 tumor, 4.7% G1 grading and 27.4% of the pts were node negative. None of these factors were statistically significant. Survival data analyses showed a disease recurrence rate of 7.6% and a mortality rate of 3.8% (n=48). With a median follow-up (FU) of 32 mon 9.9% of the pts (n=26) showing CTC relapsed compared to 7.0% of the pts (n=69) who were CTC negative (p=.124). There was no statistically significant difference seen in OAS: 15 deaths (5.7%) occurred in pts with CTC vs. 33 deaths (3.4%) in pts without CTC (p=.11). In multivariate analyses only larger tumor size, detection of lymph node metastases and negative hormone receptor status were associated with reduced DFS and OAS (p<.05, respectively). Conclusions: In contrast to our previous findings, in this cohort detection of CTC in peripheral blood of early breast cancer pts before chemotherapy was not statistically associated with DFS or OAS maybe due to the small number of events and short FU in this cohort. Further follow up will show, if this method can be used for risk stratification and monitoring of treatment efficacy in adjuvant breast cancer.
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