The impact of bone marrow disseminated tumor cells on survival and disease progression in left-sided colorectal cancer patients
Author Department
Hematology/Oncology; Medicine
Document Type
Article, Peer-reviewed
Publication Date
2-2020
Abstract
INTRODUCTION:
Disseminated tumor cells (DTC) are the subset of circulating tumor cells that migrated to the bone marrow. Colorectal cancer is a heterogeneous disease according to the location of the primary tumor.
OBJECTIVES:
The aim of this study was to analyze the relation between the presence of DTC in the bone marrow and tumor characteristics and long-term treatment results in left-sided colorectal cancer.
PATIENTS AND METHODS:
A prospective analysis of 91 left-sided colorectal cancer patients (37 with colon cancer and 54 with rectal cancer) treated between 2007 and 2012 in one tertiary center was carried out. The study included patients with following cancer stage: I-15, II-26, III-26 and IV-24 patients. Overall survival and cancer relapses were compared in patients with different cancer stages and DCT status.
RESULTS:
The DTC in bone marrow were diagnosed in 42 patients (46.1%). The prevalence of DTC in the bone marrow was not related to tumor infiltration depth, nodal involvement, distant metastasis, tumor grading nor the location of the primary tumor. The 5-year overall survival in the DTC positive group was 59.5% while for DTC negative patients 53% (p = 0.190). There was a visible trend favoring survival in patients with DTC in the bone marrow when patients with stage II and III disease were analyzed together and separately for stage II and III. There were significantly less metachronous distant metastases in DCT positive patients.
CONCLUSIONS:
The presence of DTC in the bone marrow is not associated with primary tumor characteristics and seems to diminish metastasis formation in left-sided colorectal cancer. There is also a trend for improved overall survival for DCT positive patients. These results are provocative and warrant further confirmation.
Recommended Citation
Pach R, Dylag-Trojanowska K, Baran J, Czupryna A, Siedlar M, Zybaczynska J, Brandt PH, Szczepanik AM. The impact of bone marrow disseminated tumor cells on survival and disease progression in left-sided colorectal cancer patients. Pol Arch Intern Med. 2020 Feb 20.
PMID
32077443