Oncotarget

Research Papers:

Circulating tumor cells as liquid biomarker for high HCC recurrence risk after curative liver resection

Johann von Felden, Kornelius Schulze, Till Krech, Florian Ewald, Björn Nashan, Klaus Pantel, Ansgar W. Lohse, Sabine Riethdorf and Henning Wege _

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Oncotarget. 2017; 8:89978-89987. https://doi.org/10.18632/oncotarget.21208

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Abstract

Johann von Felden1,*, Kornelius Schulze1,*, Till Krech2, Florian Ewald3, Björn Nashan3, Klaus Pantel4, Ansgar W. Lohse1, Sabine Riethdorf4 and Henning Wege1

1Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany

2Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany

3Department for Hepatobiliary and Transplant Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany

4Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany

*These authors have contributed equally to this work

Correspondence to:

Henning Wege, email: [email protected]

Keywords: hepatocellular carcinoma, CTC, BCLC A, liquid biopsy, precision medicine

Received: July 13, 2017    Accepted: July 31, 2017    Published: September 23, 2017

ABSTRACT

Background: Early hepatocellular carcinoma (HCC) has a limited prognosis due to recurrence rates of more than 50% after liver resection. Recurrence within two years is believed to be caused by untraceable micro metastases at the time of resection. The objective of this study was to investigate EpCAM-positive circulating tumor cells (CTC) as liquid biomarker to identify patients with high risk of recurrence after liver resection.

Methods: 61 patients undergoing resection between 2011 and 2015 were consecutively enrolled. Blood specimens were obtained prior to surgery and processed with the CellSearchTM system, detecting EpCAM-positive CTC. The primary endpoint was recurrence-free survival (RFS).

Results: 13 women and 44 men (63.6 ± 11.1 years) were finally evaluated. CTC-positive patients had a significantly higher risk of recurrence with a hazard ratio (HR) of 2.3 (p=0.027), and a shorter RFS compared to CTC-negative patients (5.0 ± 1.5 vs. 12.0 ± 2.5 months, p=0.039). As expected, incomplete resection (R1) was also associated with shorter RFS (HR=2.6, p=0.035), but vascular invasion was not. However, the predictive power of CTC status was independent of R1.

Conclusion: Bloodstream detection of CTC prior to curative-intended liver resection discloses an elevated risk of HCC recurrence and could identify patients, who might benefit from adjuvant treatment.


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