Abstract
Isolation and characterization of circulating tumor cells (CTCs) in patients suffering from a variety of different cancers have become hot biomarker topics. In this study, we evaluated the prognostic value of CTCs in pancreatic cancer. Initial literature was identified using Medline and EMBASE. The primary data were hazard ratios (HRs) with 95% confidence intervals (CIs) of survival outcomes, including overall survival (OS) and progression free survival/recurrence free survival (PFS/RFS). A total of 9 eligible studies were included in this meta-analysis, published between 2002 and 2013. The estimated pooled HR and 95%CI for OS for all studies was 1.64 (95%CI 1.39-1.94, p<0.00001) and the pooled HR and 95%CI for RFS/DFS was 2.36 (95%CI 1.41-3.96, p<0.00001). The HRs and 95%CIs for OS and RFS/ DFS in patients before treatment were 1.93 (95%CI 1.26-2.96, p=0.003) and 1.82 (95%CI 1.22-2.72, p=0.003), respectively. In patients receiving treatment, the HRs and 95%CI for OS and RFS/DFS were 1.37 (95%CI 1.00- 1.86, p=0.05) and 1.89 (95%CI 1.01-3.51, p=0.05), respectively. Moreover, the pooled HR and 95%CI for OS in the post-treatment group was 2.20 (95%CI 0.80-6.02, p=0.13) and the pooled HR for RFS/DFS was 8.36 (95%CI 3.22-21.67, p<0.0001). The meta-analysis provided strong evidence supporting the proposition that CTCs detected in peripheral blood have a fine predictive role in pancreatic patients especially on the time point of post-treatment.
Highlights
Pancreatic cancer, with a patient survival rate among the worst of any solid cancer, is the fourth leading cause of cancer-related morbidity and mortality in Western countries (Tjensvoll et al, 2013)
Pancreatic cancer can be screened using Sialic acid Lewis antigen CA 19-9 (CA19-9) and carcinoembryonic antigen (CEA), which are serum-based biomarkers mainly used as auxiliary indicator for early diagnosis, their utility are notoriously variable among patients (Kokhanenko et al, 2001)
We identified 9 eligible studies which assessed the prognostic value of circulating tumor cells (CTCs) detection by CellSearch system as well as the PCR-based molecular assays
Summary
Pancreatic cancer, with a patient survival rate among the worst of any solid cancer, is the fourth leading cause of cancer-related morbidity and mortality in Western countries (Tjensvoll et al, 2013). It leads to an estimated 227, 000 deaths per year worldwide and the 5 year survival rate is only 4.6% due to its early metastasis (Zhou et al, 2011). Conclusions: The meta-analysis provided strong evidence supporting the proposition that CTCs detected in peripheral blood have a fine predictive role in pancreatic patients especially on the time point of post-treatment
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