Abstract 1146
Aim/Background
To identify DTC in bone marrow (BM) as a therapeutically significant target to predict survival of patients with stage IV gastric cancer.
Methods
A total of 27 patients with advanced gastric cancer were enrolled, median age 52 years. All patients received thriplet chemotherapy. Baseline BM-DCT were identified by flow cytometry. BM-DTC positivity was defined as at least 1 tumor cell per 10 million myelokaryocytes.
Results
BM-DTC were found in 18 of 27 patients. Median survival was 6.5 months in BM-DTC positive vs. 9.2 months in BM-DTC negative patients (p = 0.019). The table below summarizes the clinicomorphological findings. Table. Relationship between DTC-positivity and clinicomorphological parameters.
| Parameter | BM-DTC positive patients n, % | BM-DTC negative patients n, % | p-Value |
|---|---|---|---|
| Tumor site | |||
| Esophagogastric junction | 9/18 (50) | 1/9 (11.1) | 0.049 |
| Body of stomach | 6/18 (33.3) | 4/9 (44.4) | 0.573 |
| Anthrum | 3/18 (16.7) | 2/9 (22.2) | 0.726 |
| Total stomach | 0/18 (0) | 2/9 (22.2) | 0.038 |
| Adenocarcinoma histology | |||
| Moderately differentiated | 4/18 (22.2) | 2/9 (22.2) | 1 |
| Poorly differentiated | 10/18 (55.6) | 1/9 (11.1) | 0.027 |
| Signet-ring cell | 4/18 (22.2) | 6/9 (66.7) | 0.024 |
| Metastasis sites | |||
| Liver | 6/18 (33.3) | 3/9 (33.3) | 1 |
| Peripheral lymph nodes | 4/18 (22.2) | 3/9 (33.3) | 0.535 |
| Retroperitoneal lymph nodes | 8/18 (44.4) | 2/9 (22.2) | 0.260 |
| Ovaries | 1/18 (5.6) | 1/9 (11.1) | 0.603 |
| Peritoneal carcinomatosis | 9/18 (50) | 8/9 (88.9) | 0.049 |
Conclusions
The presence of DTC in BM of patients with advanced gastric cancer is a poor prognostic factor associated with a high risk of early progression. BM-DTC were identified significantly more frequently in cases with EGJ and total gastric cancer, and in patients free from peritoneal carcinomatosis; there was also a correlation with tumor histology. The study is in ongoing
Clinical trial identification
Disclosure
All authors have declared no conflicts of interest.