Circulating tumor cells in patients undergoing androgen deprivation therapy with versus without cryosurgery for metastatic prostate cancer: a retrospective analysis

World Journal of Surgical Oncology

Shanming Guo¹  Chunxiao Liu²  Mingxiong Sheng³ 

[1] Department of Urology, Mindong Hospital affiliated to Fujian Medical University, 355000, Fuan, Fujian Province, People’s Republic of China;Department of Urology, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Rd., 510282, Guangzhou, Guangdong Province, People’s Republic of China;Department of Urology, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Rd., 510282, Guangzhou, Guangdong Province, People’s Republic of China;Department of Urology, Mindong Hospital affiliated to Fujian Medical University, 355000, Fuan, Fujian Province, People’s Republic of China;

关键词: Prostate cancer;    Cryosurgery;    Androgen deprivation therapy;    Circulating tumor cell;   

DOI  :  10.1186/s12957-021-02455-4

来源: Springer

【 摘 要 】

BackgroundThe study aimed to assess the value of circulating tumor cells (CTCs) as a prognostic and treatment response marker in patients undergoing androgen deprivation therapy (ADT) plus cryosurgery vs. ADT alone for metastatic prostate cancer (mPCA).MethodsThis retrospective analysis included 43 patients with mPCA: 23 receiving ADT alone (control) and 20 receiving additional cryosurgery (cryosurgery group). CTCs and progression-free survival (PFS) were compared between the two groups. Cox proportional hazards regression was conducted to identify variables associated with PFS.ResultsMedian PFS was 35 months (IQR, 33‑37) in the cryosurgery group vs. 30 months (IQR, 27‑32) in the control (p < 0.001). CTCs count was significantly lower in the cryosurgery group at both 3 months (z = 2.170, p = 0.030) and 12 months (z = 2.481; p = 0.013). In comparison to the baseline, the number of CTCs at both 3 and 12 months was lower in the cryosurgery group (p = 0.004 and p < 0.001, respectively), but not in the ADT alone group. In multivariate Cox regression, shorter PFS was associated with baseline PSA ≧100 ng/ml (HR 6.584, 95% CI, 5.309‑8.166), biopsy Gleason score ≧ 8 (HR 2.064, 95% CI, 1.608‑2.650), clinic T stage>T2b (HR 5.021, 95% CI, 3.925‑6.421), number of bone metastases>3 (HR 3.421, 95% CI, 2.786‑4.202), positive CTCs at 3 months post-treatment (HR 6.833, 95% CI, 5.176‑9.022), positive CTCs 1 year post-treatment (HR 6.051, 95% CI, 4.347‑8.424). Prostate cryosurgery was associated with longer PFS (HR 0.062, 95% CI, 0.048‑.080).ConclusionsCTC was a prognostic and treatment response marker for mPCA. ADT plus cryosurgery could reduce CTCs and prolong PFS vs. ADT alone in mPCA patients with low metastatic volume.

【 授权许可】

CC BY