Ruth G. McGrath

Prognostic significance of cancer cells in the circulating blood: A ten year evaluation

Abstract Seven per cent of 767 patients with cancer studied more than five and as many as ten years ago in our laboratory had positive blood samples. A similar frequency of positive blood samples was obtained when only those patients considered “curable” were tabulated, or those patients studied before, during, and after operation. The survival rate in the entire group of 767 patients was not different with regard to positive or negative blood samples, being 13 and 12 per cent, respectively. The survival rate for “curable” patients with positive blood samples was no different from the survival rate for those with negative blood samples; it was 32 per cent for each category. Although there is no apparent difference in the five to ten year survival rates of all 767 cancer patients, regardless of whether the blood samples are positive or negative, a definite trend is apparent in the decreased survival of patients with a shower of circulating cancer cells during or after operation. Only two of twenty-three patients (8 per cent) with showers of cancer cells demonstrated during operation were alive and well five to ten years postoperatively as compared with a 16 per cent survival (26 of 182) of patients with negative blood samples at all times before, during, and after operation. Also, vascular metastases developed in 39 per cent of those patients with showers of circulating cancer cells during operation as compared with only 18 per cent of those patients with all negative blood samples.