Abstract 4152: The detection of circulating tumor cells is a negative prognostic factor in pancreatic cancer

Purpose: We tested the hypothesis that the presence of CTC is a negative prognostic factor in patients with pancreatic cancer. Pancreatic cancer is one of the most aggressive malignancies with the poor prognosis. Assessment of the circulating tumor cells (CTC) in patients with this highly malignant disease could prevent burdensome surgery in patients with systemic dissemination. Patients and methods: This was a prospective study to test for the presence of CTC in systemic blood, portal blood, bone marrow and peritoneal lavage in 90 pancreatic cancer patients at the time of surgery using real-time RT-PCR for carcinoembryonic antigen (CEA), epidermal growth factor receptor 1 (EGFR1) and human telomerase (hTERT). Absolute gene expressions of tested markers were correlated with clinical/pathological characteristics and survival parameters. Results: Overall, 51 of 90 (56.6%) pancreatic cancer patients died, the overall survival median was 8.8 months. We found a statistically significant association between EGFR and hTERT expression levels in the portal blood and clinical stage. We also showed high expression of EGFR and CEA in the peritoneal lavage of patients with metastatic disease, in contrast to patients without the presence of the metastases. CTC positive patients measured as hTERT in tumor draining blood and CEA in bone marrow showed significantly poorer overall survival (OS) (p=0.005/ p=0.001). We also found statistically significant shorter OS in patients with EGFR positive peritoneal lavage (p=0.01). Conclusion: The results of this study demonstrate a high sensitivity and specificity of the real-time RT-PCR method for CTC detection in pancreatic cancer. Detection of CTC seems to be negative prognostic factor for overall survival in pancreatic cancer and can influence the radical surgery decision. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4152. doi:10.1158/1538-7445.AM2011-4152