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P07.04-YI

EpCAM-POSITIVE CIRCULATING TUMOR CELLS AS
LIQUID BIOMARKER FOR EARLY MICROMETASTASES
AND HCC RECURRENCE RISK

1
3
* 1
2
Johann Von Felden , Kornelius Schulze , Till Krech , Florian Ewald , Björn
Nashan , Klaus Pantel , Ansgar W Lohse , Sabine Riethdorf , Henning Wege 1
3
4
1
4
2
1 I. Dept. of Internal Medicine, Institute of Pathology, Dept. of Hepatobiliary and Transplant
3
Surgery, Institute of Tumor Biology, University Medical Centre Hamburg-Eppendorf, Hamburg,
4
20246, Germany
Corresponding author’s email: j.von-felden@uke.de
Introduction: Without liver transplantation, early HCC (BCLC stage A) has a limited
prognosis due to recurrence rates of up to 70% after curative resection or ablation.
Recurrence within two years is believed to be caused by intrahepatic micrometastases
untraceable by current imaging techniques. Recently, we have demonstrated that the
presence of EpCAM-positive circulating tumor cells (CTC) is associated with systemic
disease and inferior overall survival (Schulze et al., Int J Cancer 2013). ePOSTER ABSTRACTS
Aims: Hence, the aim of this study was to investigate CTC detection as liquid biopsy to
identify patients with high HCC recurrence risk.

Material and Methods: 67 patients undergoing HCC resection between 2011 and 2015
were prospectively enrolled. 24 hours prior to surgery, blood specimens were obtained, and
processed with the CellSearch TM system, detecting and enumerating EpCAM-positive/
keratin-positive CTC. Ten patients with incomplete data regarding HCC recurrence,
secondary liver transplantation, or perioperative death were excluded. Primary endpoint
was recurrence free survival (RFS). Tumor grading, tumor size, angioinvasion, and
resection margins were also assessed as predictors for RFS.
Results: 13 women and 44 men (63.6±11.1 years) were enrolled. Baseline characteristics
were equally distributed between patients with and without CTC. CTC positive patients
had a significantly higher recurrence risk with a hazard ratio (HR) of 2.3 compared to
CTC negative patients (p=0.027). Furthermore, RFS for CTC positive patients was
significantly shorter with a median of 5.0±1.5 months compared to 12.0±2.5 months in
CTC negative patients (p=0.039). As expected, incomplete resection (R1) was identified
as an additional parameter associated with shorter RFS (HR=2.7, p=0.035), but the

EASL HCC Summit • Geneva, Switzerland • 2-5 February, 2017 249