The presence of circulating tumor cells does not predict extravesical disease in bladder cancer patients prior to radical cystectomy

Thomas J. Guzzo, Brian K. McNeil, Trinity J. Bivalacqua, Debra J. Elliott, Lori J. Sokoll, Mark P. Schoenberg

Research output: Contribution to journalArticle

32 Scopus citations

Abstract

Objective: Due to imprecise clinical staging, the finding of extravesical and node-positive disease at the time of radical cystectomy (RC) for patients with clinically localized bladder cancer is not uncommon. Circulating tumor cells (CTCs) have been shown to be present in the peripheral blood of patients with metastatic urothelial carcinoma. The object of this study was to evaluate the ability of CTCs to predict extravesical disease in bladder cancer patients prior to RC. Materials and methods: Peripheral blood samples from 43 patients with bladder cancer were evaluated using the CellSearch (Veridex, LLC, Raritan, NJ) CTC assay prior to RC. The sensitivity, specificity, and positive predictive value (PPV) of CTC status in predicting extravesical disease was calculated. Receiver operating characteristic (ROC) curves were generated to quantify the ability of CTCs to predict extravesical and node-positive disease. Results: CTCs were detected in 9 (21%) patients prior to RC. The sensitivity, specificity, and PPV of CTC status in predicting extravesical disease were 27%, 88% and 78%, respectively. The accuracy of CTC status in predicting extravesical (≥pT3 or node-positive) disease for the entire cohort was 0.576. In a model incorporating preoperative hydronephrosis, CTC status did not improve the predictive accuracy for extravesical disease (0.576 vs. 0.585, P = 0.915). Conclusion: CTCs were detected in low numbers in a small percentage (21%) of patients prior to undergoing RC at our institution. CTC status was not a robust predictor of extravesical or node-positive disease in this cohort. CTC status is not likely to be a clinically useful parameter for directing therapeutic decisions in patients with ≤cT2 bladder cancer.

Original languageEnglish (US)
Pages (from-to)44-48
Number of pages5
JournalUrologic Oncology: Seminars and Original Investigations
Volume30
Issue number1
DOIs
StatePublished - Jan 1 2012
Externally publishedYes

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Keywords

  • Bladder cancer
  • Circulating tumor cells
  • Staging

ASJC Scopus subject areas

  • Oncology
  • Urology

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