Significance of circulating tumor cells in osteosarcoma patients treated by neoadjuvant chemotherapy and surgery
Open accessAbstract
Purpose: By examining and identifying circulating tumor cell (CTC) counts and subtypes of peripheral blood in osteosarcoma patients, we evaluated the relationship between CTCs and characteristics of osteosarcoma patients, as well as CTC changes after neoadjuvant chemotherapy and surgery. Methods: CanPatrol™ CTC technology was used to detect CTCs in peripheral blood before and after treatment in 32 osteosarcoma patients. Peripheral blood samples from 10 healthy volunteers were included as controls and examined for the presence of CTCs. Results: Of the 32 osteosarcoma patients, CTCs were detected in 30 patients before treatment, and the average CTC count was 14.06±9.08. No CTCs were detected in the 10 healthy volunteers. The detected CTCs were divided into epithelial CTCs, mesenchymal CTCs (M-CTCs), and biophenotypic epithelial/mesenchymal CTCs. The average number of pretreatment CTCs was higher in stage III patients than in stage IIB patients ( P =0.012). Twenty-eight patients were screened for changes in CTC count at 1 week after neoadjuvant chemotherapy and at 4 weeks after surgery. We divided these 28 patients into two groups according to the changes in the percentage of M-CTCs before and after treatment, and the results showed that the disease-free survival (DFS) was significantly shorter in the M-CTC percentage-increased group than in the M-CTC percentage-decreased or no-change group ( P =0.032). Five patients with stage II osteosarcoma were examined for CTCs at the appearance of lung metastases, and the total number of CTCs was found to be higher at the appearance of lung metastases than before treatment in these patients. Conclusion: The rate of presence of CTCs in the peripheral blood of osteosarcoma patients is high, and patients with an increased percentage of M-CTCs after treatment have a shorter DFS. The dynamic monitoring of changes in CTC counts after treatment has clinical significance for the timely detection of recurrence or metastasis. Keywords: circulating tumor cells, osteosarcoma, neoadjuvant chemotherapy, surgery
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In osteosarcoma, CTC burden, phenotype, and dynamic changes have been associated with metastatic disease, treatment response, and prognosis.
“In osteosarcoma, CTC burden, phenotype, and dynamic changes have been associated with metastatic disease, treatment response, and prognosis [ 25 , 26 , 27 , 28 ].”
From Signals Alongside Scans: A Genomics-Guided Framework for Liquid Biopsy in Bone and Soft-Tissue Sarcomas (2026) · cites this paper as [27]
The broader application of CTC-based methods across soft-tissue sarcomas remains limited by platform heterogeneity and uncertain prevalence.
“CTC-based methods provide complementary biological information, particularly in osteosarcoma, but their broader application across soft-tissue sarcomas remains limited by platform heterogeneity and uncertain prevalence [ 25 , 26 , 27 , 28 , 29 , 39 ].”
From Signals Alongside Scans: A Genomics-Guided Framework for Liquid Biopsy in Bone and Soft-Tissue Sarcomas (2026) · cites this paper as [27]
CTC-based methods provide complementary biological information, particularly in osteosarcoma.
“CTC-based methods provide complementary biological information, particularly in osteosarcoma, but their broader application across soft-tissue sarcomas remains limited by platform heterogeneity and uncertain prevalence [ 25 , 26 , 27 , 28 , 29 , 39 ].”
From Signals Alongside Scans: A Genomics-Guided Framework for Liquid Biopsy in Bone and Soft-Tissue Sarcomas (2026) · cites this paper as [27]
CTC detection is technically difficult in mesenchymal tumors, especially when platforms rely on epithelial markers such as EpCAM or cytokeratins.
“However, CTC detection is technically difficult in mesenchymal tumors, especially when platforms rely on epithelial markers such as EpCAM or cytokeratins.”
From Signals Alongside Scans: A Genomics-Guided Framework for Liquid Biopsy in Bone and Soft-Tissue Sarcomas (2026) · cites this paper as [27]
Broad plasma panels, CNA-based WGS, methylation-based assays, cfRNA approaches, and CTC-based strategies remain more exploratory or proof-of-concept in most sarcoma subtypes, particularly when applied to low-volume MRD or routine surveillance settings.
“In contrast, broad plasma panels, CNA-based WGS, methylation-based assays, cfRNA approaches, and CTC-based strategies remain more exploratory or proof-of-concept in most sarcoma subtypes, particularly when applied to low-volume MRD or routine surveillance settings [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ].”
From Signals Alongside Scans: A Genomics-Guided Framework for Liquid Biopsy in Bone and Soft-Tissue Sarcomas (2026) · cites this paper as [27]
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References 22 · Cited by 33
- Authors
- Wu, Z.-J., Tan, J.-C., Qin, X., Liu, B., & Yuan, Z.-C.
- Affiliations
- Guangxi Medical University (CN)
- Corresponding author
- Qin, Xiong
- Liu, Bin
- ORCID
- Venue
- Cancer Management and Research
- Publisher
- Informa UK Limited
- Published
- 2018-09
- Volume
- Volume 10
- Pages
- 3333-3339
- ISSN
- 1179-1322 (ISSN-L)
- PMC
- PMC6138968
- OpenAlex
- W2891956256
- Cited by
- 33
- References
- 22
- Citations by year
- 2026: 6 · 2025: 2 · 2024: 5 · 2023: 3 · 2022: 4 · 2021: 4 · 2020: 3 · 2019: 6
- FWCI
- 2.45
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Cancer Management and Research (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Sarcoma Diagnosis and Treatment
- Health Sciences › Medicine › Oncology › Cancer Cells and Metastasis
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer Genomics and Diagnostics
- Keywords
- circulating tumor cells, osteosarcoma, neoadjuvant chemotherapy, mesenchymal CTCs, disease-free survival, lung metastasis, tumor recurrence detection, treatment response monitoring, tumor stage
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