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Open AccessArticle

Non-Metastatic Esophageal Adenocarcinoma: Circulating Tumor Cells in the Course of Multimodal Tumor Treatment

1
Department of General and Visceral Surgery, Medical Center—University of Freiburg, 79106 Freiburg, Germany
2
Medical Faculty, University of Freiburg, 79106 Freiburg, Germany
3
Institute for Surgical Pathology, Medical Center—University of Freiburg, 79106 Freiburg, Germany
4
Department of Pathology & Andrew L. Warshaw, MD Institute for Pancreatic Cancer Research, Massachusetts General Hospital/Harvard Medical School, Boston, MA 02114, USA
*
Author to whom correspondence should be addressed.
Contributed equally and share last authorship.
Cancers 2019, 11(3), 397; https://doi.org/10.3390/cancers11030397
Received: 15 February 2019 / Revised: 16 March 2019 / Accepted: 18 March 2019 / Published: 21 March 2019
(This article belongs to the Special Issue Liquid Biopsy for Cancer)
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Abstract

Background: Isolation of circulating tumor cells (CTC) holds the promise to improve response-prediction and personalization of cancer treatment. In this study, we test a filtration device for CTC isolation in patients with non-metastatic esophageal adenocarcinoma (EAC) within recent multimodal treatment protocols. Methods: Peripheral blood specimens were drawn from EAC patients before and after neoadjuvant chemotherapy (FLOT)/chemoradiation (CROSS) as well as after surgery. Filtration using ScreenCell® devices captured CTC for cytologic analysis. Giemsa-stained specimens were evaluated by a cytopathologist; the cut-off was 1 CTC/specimen (6 mL). Immunohistochemistry with epithelial (pan-CK) and mesenchymal markers (vimentin) was performed. Results: Morphologically diverse malignant CTCs were found in 12/20 patients in at least one blood specimen. CTCs were positive for both vimentin and pan-CK. More patients were CTC positive after neoadjuvant therapy (6/20 vs. 9/15) and CTCs per/ml increased in most of the CTC-positive patients. After surgery, 8/13 patients with available blood specimens were still CTC positive. In clinical follow-up, 5/9 patients who died were CTC-positive. Conclusions: Detection of CTC by filtration within multimodal treatment protocols of non-metastatic EAC is feasible. The rate of CTC positive findings and the quantity of CTCs changes in the course of multimodal neoadjuvant chemoradiation/chemotherapy and surgery. View Full-Text
Keywords: esophageal cancer; adenocarcinoma; circulating tumor cells; metastasis; chemotherapy; chemoradiation; surgery esophageal cancer; adenocarcinoma; circulating tumor cells; metastasis; chemotherapy; chemoradiation; surgery
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Kuvendjiska, J.; Bronsert, P.; Martini, V.; Lang, S.; Pitman, M.B.; Hoeppner, J.; Kulemann, B. Non-Metastatic Esophageal Adenocarcinoma: Circulating Tumor Cells in the Course of Multimodal Tumor Treatment. Cancers 2019, 11, 397.

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