Disseminated Tumour Cells (DTC) in Left Sided Colorectal Cancer (LSCC).

Jagiellonian University

Status: Completed

Conditions: Bone Marrow Tumor Cell Infiltration; Colorectal Cancer

Treatments: Diagnostic Test: Bone marrow analysis to identify disseminated tumour cells

Study type: Observational

Funder types: Other

Identifiers

NCT03640572

DCT LSCC

Details and patient eligibility

About

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.

Full description

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%.

Enrollment: 91 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• age > 18 years
• histologically proven left-sided colorectal cancer
• signed informed consent

Exclusion criteria

• synchronous right sided colon cancer
• history of other neoplasm
• inability to understand and sign informed consent

Trial design

91 participants in 2 patient groups

Bone Marrow DTC

Description:

Patients with left-sided colorectal cancer and disseminated tumour cells in the bone marrow

Treatment:

Diagnostic Test: Bone marrow analysis to identify disseminated tumour cells

No bone marrow DTC

Description:

Patients with left-sided colorectal cancer and no disseminated tumour cells in the bone marrow

Treatment:

Diagnostic Test: Bone marrow analysis to identify disseminated tumour cells