Journal: Oncogene
This prospective study evaluated circulating tumor cells (CTCs) as a non-invasive biomarker in women with advanced high-grade serous ovarian cancer (FIGO IIIC–IV) undergoing primary cytoreductive surgery.
Key details:
- Population: 56 women with advanced disease; 9 with benign ovarian disease as controls.
- Sampling: 7.5 mL peripheral blood pre- and post-operatively.
- Follow-up: Median 35.4 months.
Findings:
- CTC detection:
- Pre-operative: 48.2% (27/56) of patients.
- Post-operative: 46.4% (26/56).
- No CTCs detected in benign controls.
- Pre-operative CTC positivity was significantly associated with:
- Suboptimal cytoreduction (OR 15.6; 95% CI 2.97–127.0; p=0.0031).
- Worse platinum response (p=0.0173).
- Presence of lymph node metastases (p=0.0151).
- Shorter progression-free survival (PFS; p=0.0045).
- Shorter overall survival (OS; p=0.0241).
- Post-operative assessment:
- Combining post-operative CTC status with residual tumor burden was significantly associated with worse OS (p=0.047).
- Multivariable analysis: Pre-operative CTCs remained an independent surrogate marker for:
- Incomplete debulking.
- Platinum resistance.
- Poor survival.
Clinical implications:
- Quantification of CTCs before and after surgery may help:
- Predict surgical resectability and platinum response.
- Stratify prognosis.
- Guide treatment selection (e.g., surgical aggressiveness vs. alternative approaches).
- Optimize resource allocation and improve patient counseling in advanced high-grade serous ovarian cancer.