Colorectal Cancer Clinical Trial
Official title:
Prognostic Value of Disseminated Tumour Cells in Bone Marrow in Patients With Left-sided Colorectal Cancer.
Two metaanalyses of studies on the prognostic significance of circulating cancer cells in
colorectal cancer indicated, that the presence of circulating tumour cells (CTC) in the
peripheral blood is the negative prognostic factor. However there is no sufficient evidence
that disseminated tumour cells (DTC) in the bone marrow of the colorectal cancer patients
influence the prognosis. There is the evidence that right-sided and left- sided cancers may
have different biology and different prognosis. Therefore in this study the investigators
concentrated on the left colon and rectum locations with the locally advanced cancer being
the main area of interest.
The aim of this study was to analyse the relation of DTC with the tumor characteristics,
cancer progression and survival in left sided colorectal cancer.
A group of 91 colorectal patients treated in a single institution was involved into the
study. Only the patients with tumors located in the rectum or left side colon were included.
The term left colon was defined as the left 1/3 of transverse colon and all the colon parts
distally from this point. None of the colon cancer patients received preoperative
chemotherapy, while 5 of the rectal cancer patients received preoperative radiotherapy and
two preoperative radiochemotherapy. There were 42 women and 49 men, the mean age 64,7 (SD -
standard deviation 10,2). The bone marrow biopsy was performed on the day of surgery after
the induction of general anesthesia from posterior superior iliac spine. The 5ml sample of
the bone marrow was collected to plastic tubes containing EthyleneDiamineTetraacetic (EDTA).
Patients received postoperative chemotherapy if indicated, regardless of their DTC status.
All the patients were followed up at least for 5 years or until death.
The incidence of DTC was not related to the depth of infiltration (T feature) being similar
in T1-2 and T4 patients. There was no statistically significant difference between the
incidence of DTC in N- and N+ patients. The 5 years survival rate for the DTC patients was
59,5% while for the DTC negative patients was 53%.
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