LBA1 - Detection of circulating tumor cells and early recurrence in patients undergoing radical resection for non-small-cell lung cancer

Date 17 April 2015
Event ELCC 2015
Session ESMO-IASLC Best Abstracts
Topics Non-Small-Cell Lung Cancer, Metastatic
Translational Research
Presenter Clara Bayarri-Lara
Citation Annals of Oncology (2015) 0 (0): 1-8. 10.1093/annonc/mdv128
Authors C.I. Bayarri-Lara1, M.J. Serrano2, C.F. Giraldo1, F.G. Ortega2, F.J. Ruiz-Zafra1, A. Sánchez-Palencia1, J.L. García-Puche3, M. Delgado-Rodriguez4, J.A. Navajas1, A. Cueto1
  • 1Thoracic Surgery Department, Hospital Universitario Virgen de las Nieves, 18014 - Granada/ES
  • 2Oncological Research, Centre for Genomic Researchs (GENyO), Granada/ES
  • 3Oncology Department, Hospital Clinico San Cecilio, Granada/ES
  • 4Preventive Medicine, University of Jaén, Jaen/ES



Despite optimal surgical treatment for non-small-cell lung cancer (NSCLC) a considerable percentage of patients will relapse and die of recurrent disease. Increasing evidence suggests that relapse may arise from circulating tumor cells (CTCs) present in patient´s blood. This study investigates whether CTCs are detectable in patients undergoing radical resection for NSCLC and their clinical and prognostic utility.


56 patients who underwent radical surgery for previously untreated NSCLC were prospectively enrolled. Blood samples for CTCs analysis were obtained before and one month after surgery. CTCs were isolated by two methods based in inmunomagnetic technique and isolation by size. In addition CTCs were phenotypic characterized by epidermal growth factor receptor (EGFR) expression. Patients were considered CTC+ if at least one CTC was captured.


CTCs were detected in 29 patients (51.8%) before surgery and in 18 (32.1%) one month later (p=0.035). For CTC+ cases the median number of CTCs was 3 before surgery and 2 after the operation. EGFR expression at baseline was 89.7% and 38.9% after surgery.

CTC prevalence was significantly lower after pneumonectomy compared to other resections (p=0.034). CTC count in the second detection was correlated with max SUV of PET scan (p=0.046). There was no significant correlation between CTC presence or number and any other parameter analysed.

With a median follow up of 16 months 16 patients developed an early recurrence (28.6%). CTC presence after surgery was significantly associated with early recurrence (p=0.018) and a shorter disease free survival (DFS), with a 1-year DFS rate of 51% compared to 87.7% for CTC negative group after surgery (log rank test p=0.008). In multivariate analysis CTC presence after surgery and N status were independent prognostic factors for DFS.


CTCs can be detected and characterized in patients undergoing radical resection for NSCLC. Results suggest that CTCs detection may contribute to risk stratification identifying patients with increased risk of early recurrence. A broader study necessary for further validation of prognostic significance of CTCs in these patients is currently being performed.


All authors have declared no conflicts of interest.