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Circulating tumor cells and early relapse in node-positive melanoma.

淋巴结阳性黑色素瘤的循环肿瘤细胞与早期复发。

  • 影响因子:8.32
  • DOI:10.1158/1078-0432.CCR-19-2670
  • 作者列表:"Lucci A","Hall C","Patel SP","Narendran B","Bauldry JB","Royal R","Karhade M","Upshaw JR","Wargo JA","Glitza IC","Wong MKK","Amaria RN","Tawbi HA","Diab A","Davies MA","Gershenwald JE","Lee JE","Hwu P","Ross MI
  • 发表时间:2020-02-03
Abstract

PURPOSE:There is a need for sensitive, reproducible biomarkers for stage III melanoma patients to guide clinical decision making. Circulating tumor cells (CTCs) can be detected in melanoma patients; however, there is limited data regarding their significance in stage III disease. The aim of this study was to determine if CTCs are associated with early relapse in stage III melanoma. EXPERIMENTAL DESIGN:We prospectively assessed CTCs at first presentation in clinic (baseline) for 243 stage III melanoma patients. CTCs were measured using the CellSearch System. Relapse-free survival (RFS) was compared between patients with one or more baseline CTC versus those with no CTCs. Log-rank test and Cox regression analysis were applied to establish associations of CTCs with RFS. RESULTS:At least one baseline CTC was identified in 90/243 (37%) patients. Forty-five (19%), 67 (28%), 118 (49%), and 13 (5%) patients were stage IIIA, IIIB, IIIC, or IIID, respectively. CTC detection was not associated with sub stage, or primary tumor characteristics. Multivariable analysis demonstrated that the detection of ≥1 baseline CTC was significantly associated with decreased 6 month RFS (log-rank p <0.0001, hazard ratio (HR) 3.62, 95% confidence interval (CI) 1.78 to 7.36; P <0.0001) and 54 month RFS (log-rank p = 0.01, HR 1.69, CI 1.13 to 2.54; P = 0.01). CONCLUSION:≥1 CTC was independently associated with melanoma relapse, suggesting that CTC assessment may be useful to identify patients at risk for relapse who could derive benefit from adjuvant therapy.

摘要

目的: 对于III期黑色素瘤患者,需要敏感、可重复的生物标志物来指导临床决策。循环肿瘤细胞 (CTCs) 可以在黑色素瘤患者中检测到; 然而,关于其在III期疾病中的意义的数据有限。本研究的目的是确定CTCs是否与III期黑色素瘤早期复发相关。 实验设计: 我们前瞻性评估了 243 例III期黑色素瘤患者在临床首次就诊时 (基线) 的CTCs。使用CellSearch系统测量CTCs。比较了一个或多个基线CTC与无CTC患者的无复发生存期 (RFS)。应用Log-rank检验和Cox回归分析建立CTCs与RFS的相关性。 结果: 在 90/243 例 (37%) 患者中发现至少一个基线CTC。IIIA、IIIB、IIIC或IIID期患者分别为 45 例 (19%) 、 67 例 (28%) 、 118 例 (49%) 和 13 例 (5%)。CTC检测与亚分期或原发肿瘤特征无关。多变量分析表明,检测到 ≥ 1 个基线CTC与降低 6 个月RFS显著相关 (log-rank p <0.0001,风险比 (HR) 3.62,95% 置信区间 (CI) 1.78 比 7.36; P <0.0001) 和 54 个月RFS (log-rank p = 0.01,HR 1.69,CI 1.13 ~ 2.54; P = 0.01)。 结论: ≥ 1 CTC与黑色素瘤复发独立相关,提示CTC评估可能有助于确定有复发风险的患者,这些患者可以从辅助治疗中获益。

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影响因子:6.50
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来源期刊:Cancer letters
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