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Circulating Tumour Cells as an Independent Prognostic Factor in Patients with Advanced Oesophageal Squamous Cell Carcinoma Undergoing Chemoradiotherapy

Lookup NU author(s): Dr Chiao-En Wu



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© The Author(s) 2016. The role of circulating tumour cells (CTCs) in advanced oesophageal cancer (EC) patients undergoing concurrent chemoradiotherapy (CCRT) remains uncertain. A negative selection protocol plus flow cytometry was validated to efficiently identify CTCs. The CTC number was calculated and analysed for survival impact. The protocol's efficacy in CTC identification was validated with a recovery rate of 44.6 ± 9.1% and a coefficient of variation of 20.4%. Fifty-seven patients and 20 healthy donors were enrolled. Initial staging, first response to CRT, and surgery after CRT were prognostic for overall survival, with P values of <0.0001, <0.0001, and <0.0001, respectively. The CTC number of EC patients is significantly higher (P = 0.04) than that of healthy donors. Multivariate analysis for disease-specific progression-free survival showed that surgery after response to CCRT, initial stage, and CTC number (≥21.0 cells/mL) played independent prognostic roles. For overall survival, surgery after CCRT, performance status, initial stage, and CTC number were significant independent prognostic factors. In conclusion, a negative selection plus flow cytometry protocol efficiently detected CTCs. The CTC number before CCRT was an independent prognostic factor in patients with unresectable oesophageal squamous cell carcinoma. Further large-scale prospective studies for validation are warranted.

Publication metadata

Author(s): Su P-J, Wu M-H, Wang H-M, Lee C-L, Huang W-K, Wu C-E, Chang H-K, Chao Y-K, Tseng C-K, Chiu T-K, Lin NM-J, Ye S-R, Lee JY-C, Hsieh C-H

Publication type: Article

Publication status: Published

Journal: Scientific Reports

Year: 2016

Volume: 6

Online publication date: 17/08/2016

Acceptance date: 20/07/2016

Date deposited: 13/04/2017

ISSN (electronic): 2045-2322

Publisher: Nature Publishing Group


DOI: 10.1038/srep31423


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Funder referenceFunder name
Chang Gung Memorial Hospital Grants CMRPG3E1631-32, CMRPG3E0511-12 to C.H. Hsieh,
CMRPD2D0041-42 to M.H. Wu.
NMRPD1E011 to H.M. Wang
National Science Council Grants MOST 103-2314-B-182A-064- and 105-2314-B-182A-030-;