Presence of bone marrow micro-metastases in stage I-III colon cancer patients is associated with worse disease-free and overall survival

Publikation

Presence of bone marrow micro-metastases in stage I-III colon cancer patients is associated with worse disease-free and overall survival

Wissenschaftlicher Artikel/Review - 12.04.2017

Viehl Carsten T, Oertli Daniel, Sauter Guido, Terracciano Luigi, Langer Igor, Banz Vanessa, Ramser Michaela, Rosenthal Rachel, Dell-Kuster Salome, Gueller Ulrich, Weixler Benjamin, Zuber Markus

Zitation

Viehl C, Oertli D, Sauter G, Terracciano L, Langer I, Banz V, Ramser M, Rosenthal R, Dell-Kuster S, Gueller U, Weixler B, Zuber M. Presence of bone marrow micro-metastases in stage I-III colon cancer patients is associated with worse disease-free and overall survival. Cancer Med 2017; 6:918-927.

Art

Wissenschaftlicher Artikel/Review (Englisch)

Zeitschrift

Cancer Med 2017; 6

Veröffentlichungsdatum

12.04.2017

eISSN (Online)

2045-7634

Seiten

918-927

Kurzbeschreibung/Zielsetzung

The prognostic significance of bone marrow micro-metastases (BMM) in colon cancer patients remains unclear. We conducted a prospective cohort study with long-term follow-up to evaluate the relevance of BMM as a prognostic factor for disease free (DFS) and overall survival (OS) in stage I-III colon cancer patients. In this prospective multicenter cohort study 144 stage I-III colon cancer patients underwent bone marrow aspiration from both iliac crests prior to open oncologic resection. The bone marrow aspirates were stained with the pancytokeratin antibody A45-B/B3 and analyzed for the presence of epithelial tumor cells. DFS and OS were analyzed using a Cox proportional hazard model and robust standard errors to account for clustering in the multicenter setting. Median overall follow-up was 6.2 years with no losses to follow-up, and 7.3 years in patients who survived. BMM were found in 55 (38%) patients. In total, 30 (21%) patients had disease recurrence and 56 (39%) patients died. After adjusting for known prognostic factors, BMM positive patients had a significantly worse DFS (hazard ratio [HR] 1.33; 95% confidence interval [95% CI]: 1.02-1.73; P = 0.037) and OS (HR 1.30; 95% CI: 1.09-1.55; P = 0.003) compared to BMM negative patients. Bone marrow micro-metastases occur in over one third of stage I-III colon cancer patients and are a significant, independent negative prognostic factor for DFS and OS. Future trials should evaluate whether node-negative colon cancer patients with BMM benefit from adjuvant chemotherapy.