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Pre-operative circulating tumor cells predict worse treatment outcome in patients with high-grade serous ovarian cancer

Oncogene (2026)Cite this article

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Abstract

High-grade serous ovarian cancer (HGSOC) is the most lethal gynecological malignancy. Pre- and post-operative, non-invasive biomarkers for reliable treatment outcome prediction, (minimal) residual disease detection, and prognosis are not yet established in clinical practice for these patients. This prospective study quantified circulating tumor cells (CTCs) in 7.5 ml peripheral blood in 56 women with FIGO stages IIIC and IV HGSOC before and after primary cytoreductive surgery and in 9 women with benign ovarian disease. Clinical outcomes were assessed during the median follow-up of 35.4 months. CTCs were detected in 48.2% (27/56) of patients pre-operatively and in 46.4% (26/56) post-operatively, but not in benign controls. Pre-operative CTCs were associated with suboptimal cytoreductive surgery (OR = 15.6, 95% CI: 2.97–127.0, p = 0.0031), worse platinum response (p = 0.0173), lymph node metastases (p = 0.0151), and shorter progression-free (p = 0.0045) and overall survival (p = 0.0241). Post-operative CTC-augmented residual tumor was significantly associated with worse OS (p = 0.047). In multivariable analyses, pre-operative CTCs remained an independent surrogate marker for incomplete debulking, platinum resistance, and poor survival in HGSOC. Therefore, the quantification of CTCs in HGSOC pre- and post-operatively may be used to guide treatment selection, reduce surgical morbidity, improve the healthcare provider’s resource allocation and planning, and enhance patient counseling.

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References

  1. Huang J, Chan WC, Ngai CH, Lok V, Zhang L, Lucero-Prisno DE 3rd, et al. Worldwide burden, risk factors, and temporal trends of ovarian cancer: a global study. Cancers. 2022;14:2230.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Smith LH, Morris CR, Yasmeen S, Parikh-Patel A, Cress RD, Romano PS. Ovarian cancer: can we make the clinical diagnosis earlier? Cancer. 2005;104:1398–407.

    Article  PubMed  Google Scholar 

  3. Torre LA, Trabert B, DeSantis CE, Miller KD, Samimi G, Runowicz CD, et al. Ovarian cancer statistics, 2018. CA Cancer J Clin. 2018;68:284–96.

    PubMed  PubMed Central  Google Scholar 

  4. Aletti GD, Dowdy SC, Gostout BS, Jones MB, Stanhope CR, Wilson TO, et al. Aggressive surgical effort and improved survival in advanced-stage ovarian cancer. Obstet Gynecol. 2006;107:77–85.

    Article  PubMed  Google Scholar 

  5. Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF). S3-Leitlinie Diagnostik, Therapie und Nachsorge maligner Ovarialtumoren. version 5.1, AWMF-Registernummer: 032/035OL. AWMF online. Accessible from https://www.leitlinienprogramm-onkologie.de/leitlinien/ovarialkarzinom (2022).

  6. Lin Q, Liu W, Xu S, Li J, Tong J. The value of systematic lymphadenectomy during debulking surgery in the treatment of ovarian cancer: a meta-analysis of randomized controlled trials. J Ovar Res. 2020;13:56.

    Article  Google Scholar 

  7. Iida Y, Kobayashi-Kato M, Komatsu H, Ishikawa M, Satoh TGynecologic Cancer Study Group of the Japan Clinical Oncology Group Questionnaire-based survey on the extent of lymph node dissection during interval debulking surgery after neoadjuvant chemotherapy for patients with advanced ovarian cancer in the Gynecologic Cancer Study Group of JCOG. Int J Clin Oncol. 2025;30:1040–7.

    Article  PubMed  Google Scholar 

  8. Colombo N, Sessa C, du Bois A, Ledermann J, McCluggage WG, McNeish I, et al. ESMO-ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease. Ann Oncol. 2019;30:672–705.

    Article  CAS  PubMed  Google Scholar 

  9. Xu Z, Becerra AZ, Justiniano CF, Aquina CT, Fleming FJ, Boscoe FP, et al. Complications and survivorship trends after primary debulking surgery for ovarian cancer. J Surg Res. 2020;246:34–41.

    Article  PubMed  Google Scholar 

  10. National Institute for Health and Care Excellence (NICE). Interventional procedure overview of maximal cytoreductive surgery for advanced ovarian cancer. NICE. Accessible from: https://www.nice.org.uk/consultations/1769/6/summary-of-key-evidence-on-maximal-effort-cytoreductive-surgery-for-advanced-ovarian-cancer (2022).

  11. Gerestein CG, Damhuis RA, de Vries M, Reedijk A, Burger CW, Kooi GS. Causes of postoperative mortality after surgery for ovarian cancer. Eur J Cancer. 2009;45:2799–803.

    Article  CAS  PubMed  Google Scholar 

  12. Bidzinski M, Derlatka P, Kubik P, Ziolkowska-Seta I, Danska-Bidzinska A, Gmyrek L, et al. The evaluation of intra- and postoperative complications related to debulking surgery with bowel resection in patients with FIGO stage III-IV ovarian cancer. Int J Gynecol Cancer. 2007;17:993–7.

    Article  CAS  PubMed  Google Scholar 

  13. Ledermann JA, Raja FA, Fotopoulou C, Gonzalez-Martin A, Colombo N, Sessa C, et al. Newly diagnosed and relapsed epithelial ovarian carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013;24:vi24–32.

    Article  PubMed  Google Scholar 

  14. Lowe KA, Chia VM, Taylor A, O’Malley C, Kelsh M, Mohamed M, et al. An international assessment of ovarian cancer incidence and mortality. Gynecol Oncol. 2013;130:107–14.

    Article  PubMed  Google Scholar 

  15. Kang S, Kim TJ, Nam BH, Seo SS, Kim BG, Bae DS, et al. Preoperative serum CA-125 levels and risk of suboptimal cytoreduction in ovarian cancer: a meta-analysis. J Surg Oncol. 2010;101:13–7.

    Article  CAS  PubMed  Google Scholar 

  16. Vorgias G, Iavazzo C, Savvopoulos P, Myriokefalitaki E, Katsoulis M, Kalinoglou N, et al. Can the preoperative Ca-125 level predict optimal cytoreduction in patients with advanced ovarian carcinoma? A single institution cohort study. Gynecol Oncol. 2009;112:11–5.

    Article  PubMed  Google Scholar 

  17. Merlo S, Besic N, Drmota E, Kovacevic N. Preoperative serum CA-125 level as a predictor for the extent of cytoreduction in patients with advanced stage epithelial ovarian cancer. Radio Oncol. 2021;55:341–6.

    Article  Google Scholar 

  18. Joosse SA, Gorges TM, Pantel K. Biology, detection, and clinical implications of circulating tumor cells. EMBO Mol Med. 2015;7:1–11.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. He X, Li S, Ni Y, Jin M, Fu X. A meta-analysis of the prognostic value of circulating tumor cells in ovarian cancer. Am J Transl Res. 2022;14:3574–83.

    CAS  PubMed  PubMed Central  Google Scholar 

  20. Wang T, Gao Y, Wang X, Tian J, Li Y, Yu B, et al. Establishment of an optimized CTC detection model consisting of EpCAM, MUC1 and WT1 in epithelial ovarian cancer and its correlation with clinical characteristics. Chin J Cancer Res. 2022;34:95–108.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Kuhlmann JD, Wimberger P, Bankfalvi A, Keller T, Scholer S, Aktas B, et al. ERCC1-positive circulating tumor cells in the blood of ovarian cancer patients as a predictive biomarker for platinum resistance. Clin Chem. 2014;60:1282–9.

    Article  CAS  PubMed  Google Scholar 

  22. Chebouti I, Kuhlmann JD, Buderath P, Weber S, Wimberger P, Bokeloh Y, et al. ERCC1-expressing circulating tumor cells as a potential diagnostic tool for monitoring response to platinum-based chemotherapy and for predicting post-therapeutic outcome of ovarian cancer. Oncotarget. 2017;8:24303–13.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Lee M, Kim EJ, Cho Y, Kim S, Chung HH, Park NH, et al. Predictive value of circulating tumor cells (CTCs) captured by microfluidic device in patients with epithelial ovarian cancer. Gynecol Oncol. 2017;145:361–5.

    Article  PubMed  Google Scholar 

  24. Elazezy M, Prieske K, Kluwe L, Oliveira-Ferrer L, Peine S, Muller V, et al. BRCA1 promoter hypermethylation on circulating tumor DNA correlates with improved survival of patients with ovarian cancer. Mol Oncol. 2021;15:3615–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Lou E, Vogel RI, Hoostal S, Wong P, Grad A, Monu M, et al. Analysis of differentially expressed MicroRNAs and circulating tumor cells as predictive biomarkers of platinum chemoresistance in primary ovarian carcinomas: a prospective study. Oncologist. 2019;24:1422–e013.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Stuart GC, Kitchener H, Bacon M, duBois A, Friedlander M, Ledermann J, et al. 2010 Gynecologic Cancer InterGroup (GCIG) consensus statement on clinical trials in ovarian cancer: report from the Fourth Ovarian Cancer Consensus Conference. Int J Gynecol Cancer. 2011;21:750–5.

    Article  PubMed  Google Scholar 

  27. Smerage JB, Barlow WE, Hortobagyi GN, Winer EP, Leyland-Jones B, Srkalovic G, et al. Circulating tumor cells and response to chemotherapy in metastatic breast cancer: SWOG S0500. J Clin Oncol. 2014;32:3483–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Cohen SJ, Punt CJ, Iannotti N, Saidman BH, Sabbath KD, Gabrail NY, et al. Prognostic significance of circulating tumor cells in patients with metastatic colorectal cancer. Ann Oncol. 2009;20:1223–9.

    Article  CAS  PubMed  Google Scholar 

  29. de Bono JS, Scher HI, Montgomery RB, Parker C, Miller MC, Tissing H, et al. Circulating tumor cells predict survival benefit from treatment in metastatic castration-resistant prostate cancer. Clin Cancer Res. 2008;14:6302–9.

    Article  PubMed  Google Scholar 

  30. Poveda A, Kaye SB, McCormack R, Wang S, Parekh T, Ricci D, et al. Circulating tumor cells predict progression-free survival and overall survival in patients with relapsed/recurrent advanced ovarian cancer. Gynecol Oncol. 2011;122:567–72.

    Article  PubMed  Google Scholar 

  31. Liu JF, Kindelberger D, Doyle C, Lowe A, Barry WT, Matulonis UA. Predictive value of circulating tumor cells (CTCs) in newly-diagnosed and recurrent ovarian cancer patients. Gynecol Oncol. 2013;131:352–6.

    Article  PubMed  Google Scholar 

  32. Banys-Paluchowski M, Fehm T, Neubauer H, Paluchowski P, Krawczyk N, Meier-Stiegen F, et al. Clinical relevance of circulating tumor cells in ovarian, fallopian tube and peritoneal cancer. Arch Gynecol Obstet. 2020;301:1027–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Miller MC, Doyle GV, Terstappen LW. Significance of circulating tumor cells detected by the CellSearch system in patients with metastatic breast colorectal and prostate cancer. J Oncol. 2010;2010:617421.

    Article  PubMed  Google Scholar 

  34. Gao Y, Fan WH, Song Z, Lou H, Kang X. Comparison of circulating tumor cell (CTC) detection rates with epithelial cell adhesion molecule (EpCAM) and cell surface vimentin (CSV) antibodies in different solid tumors: a retrospective study. PeerJ. 2021;9:e10777.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Allard WJ, Matera J, Miller MC, Repollet M, Connelly MC, Rao C, et al. Tumor cells circulate in the peripheral blood of all major carcinomas but not in healthy subjects or patients with nonmalignant diseases. Clin Cancer Res. 2004;10:6897–904.

    Article  PubMed  Google Scholar 

  36. Biosystems MS. CellSearch Circulating Tumor Cell Kit (Epithelial) IVD REF 7900001. Menarini Silicon Biosystems Inc. 10355 Science Center Drive, Suite 210, San Diego, CA 92121, USA; 2017.

  37. Joosse SA. In-Silico Online v2.4.0 [accessed on Oct 2024]. Available from: http://in-silico.online.

  38. Joosse SA, Souche FR, Babayan A, Gasch C, Kerkhoven RM, Ramos J, et al. Chromosomal aberrations associated with sequential steps of the metastatic cascade in colorectal cancer patients. Clin Chem. 2018;64:1505–12.

    Article  CAS  PubMed  Google Scholar 

  39. Emurlai G, Pose RM, Kalra N, Coith C, Lenz S, Tennstedt P, et al. Comparative analysis of circulating tumor cells in prostatic plexus and peripheral blood of patients undergoing prostatectomy. J Exp Clin Cancer Res. 2025;44:143.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Olson MT, Ly QP, Mohs AM. Fluorescence guidance in surgical oncology: challenges, opportunities, and translation. Mol Imaging Biol. 2019;21:200–18.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Obermayr E, Castillo-Tong DC, Pils D, Speiser P, Braicu I, Van Gorp T, et al. Molecular characterization of circulating tumor cells in patients with ovarian cancer improves their prognostic significance - a study of the OVCAD consortium. Gynecol Oncol. 2013;128:15–21.

    Article  CAS  PubMed  Google Scholar 

  42. Lou E, Vogel RI, Teoh D, Hoostal S, Grad A, Gerber M, et al. Assessment of circulating tumor cells as a predictive biomarker of histology in women with suspected ovarian cancer. Lab Med. 2018;49:134–9.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Zhou Y, Bian B, Yuan X, Xie G, Ma Y, Shen L. Prognostic value of circulating tumor cells in ovarian cancer: a meta-analysis. PLoS One. 2015;10:e0130873.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Zhao H, Wang L, Fang C, Li C, Zhang L. Factors influencing the diagnostic and prognostic values of circulating tumor cells in breast cancer: a meta-analysis of 8,935 patients. Front Oncol. 2023;13:1272788.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Yao Y, Zhu X, Liu W, Jiang J, Jiang H. Meta-analysis of the prognostic value of circulating tumor cells in gastrointestinal cancer. Med (Baltim). 2022;101:e31099.

    Article  Google Scholar 

  46. Kuo YC, Chuang CH, Kuo HC, Lin CT, Chao A, Huang HJ, et al. Circulating tumor cells help differentiate benign ovarian lesions from cancer before surgery: a literature review and proof of concept study using flow cytometry with fluorescence imaging. Oncol Lett. 2024;27:234.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Abreu M, Cabezas-Sainz P, Alonso-Alconada L, Ferreiros A, Mondelo-Macia P, Lago-Leston RM, et al. Circulating tumor cells characterization revealed timp1 as a potential therapeutic target in ovarian cancer. Cells. 2020;9:1218.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Obermayr E, Bednarz-Knoll N, Orsetti B, Weier HU, Lambrechts S, Castillo-Tong DC, et al. Circulating tumor cells: potential markers of minimal residual disease in ovarian cancer? a study of the OVCAD consortium. Oncotarget. 2017;8:106415–28.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Joosse SA, Pantel K. Biologic challenges in the detection of circulating tumor cells. Cancer Res. 2013;73:8–11.

    Article  CAS  PubMed  Google Scholar 

  50. Loret N, Denys H, Tummers P, Berx G. The role of epithelial-to-mesenchymal plasticity in ovarian cancer progression and therapy resistance. Cancers. 2019;11:838.

  51. Fang D, Chen H, Zhu JY, Wang W, Teng Y, Ding HF, et al. Epithelial-mesenchymal transition of ovarian cancer cells is sustained by Rac1 through simultaneous activation of MEK1/2 and Src signaling pathways. Oncogene. 2017;36:1546–58.

    Article  CAS  PubMed  Google Scholar 

  52. Xu L, Mao X, Guo T, Chan PY, Shaw G, Hines J, et al. The novel association of circulating tumor cells and circulating megakaryocytes with prostate cancer prognosis. Clin Cancer Res. 2017;23:5112–22.

    Article  CAS  PubMed  Google Scholar 

  53. Xu L, Mao X, Grey A, Scandura G, Guo T, Burke E, et al. Noninvasive detection of clinically significant prostate cancer using circulating tumor cells. J Urol. 2020;203:73–82.

    Article  PubMed  Google Scholar 

  54. Woo HJ, Rademacher PN, Shin HY, Lee J, Intisar A, Warkiani ME, et al. Robust automated separation of circulating tumor cells and cancer-associated fibroblasts for enhanced liquid biopsy in breast cancer. Anal Chem. 2025;97:17452–61.

    Article  CAS  PubMed  Google Scholar 

  55. Koch C, Joosse SA, Schneegans S, Wilken OJW, Janning M, Loreth D, et al. Pre-analytical and analytical variables of label-independent enrichment and automated detection of circulating tumor cells in cancer patients. Cancers. 2020;12:442.

  56. Salmon C, Levermann J, Neves RPL, Liffers ST, Kuhlmann JD, Buderath P, et al. Image-based identification and genomic analysis of single circulating tumor cells in high-grade serous ovarian cancer patients. Cancers. 2021;13:3748.

  57. Blassl C, Kuhlmann JD, Webers A, Wimberger P, Fehm T, Neubauer H. Gene expression profiling of single circulating tumor cells in ovarian cancer - Establishment of a multi-marker gene panel. Mol Oncol. 2016;10:1030–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Chebouti I, Kasimir-Bauer S, Buderath P, Wimberger P, Hauch S, Kimmig R, et al. EMT-like circulating tumor cells in ovarian cancer patients are enriched by platinum-based chemotherapy. Oncotarget. 2017;8:48820–31.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Obermayr E, Braicu EI, Polterauer S, Loverix L, Concin N, Woelber L, et al. Association of a combined cancer exhaustion score with circulating tumor cells and outcome in ovarian cancer—a study of the OVCAD Consortium. Cancers. 2021;13:5865.

  60. Joosse SA, Pantel K. Genetic traits for hematogeneous tumor cell dissemination in cancer patients. Cancer Metastasis Rev. 2016;35:41–8.

    Article  CAS  PubMed  Google Scholar 

  61. Tan DS, Agarwal R, Kaye SB. Mechanisms of transcoelomic metastasis in ovarian cancer. Lancet Oncol. 2006;7:925–34.

    Article  PubMed  Google Scholar 

  62. Deng M, Yang R, Jiang J, Zhang J, He J, Miao J. The silent spread: exploring diverse metastatic pathways in high-grade serous ovarian cancer. Front Med (Lausanne). 2025;12:1539024.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Pradeep S, Kim SW, Wu SY, Nishimura M, Chaluvally-Raghavan P, Miyake T, et al. Hematogenous metastasis of ovarian cancer: rethinking mode of spread. Cancer cell. 2014;26:77–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Coffman LG, Burgos-Ojeda D, Wu R, Cho K, Bai S, Buckanovich RJ. New models of hematogenous ovarian cancer metastasis demonstrate preferential spread to the ovary and a requirement for the ovary for abdominal dissemination. Transl Res. 2016;175:92–102.e2.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Fan T, Zhao Q, Chen JJ, Chen WT, Pearl ML. Clinical significance of circulating tumor cells detected by an invasion assay in peripheral blood of patients with ovarian cancer. Gynecol Oncol. 2009;112:185–91.

    Article  CAS  PubMed  Google Scholar 

  66. Fehm T, Banys M, Rack B, Janni W, Marth C, Blassl C, et al. Pooled analysis of the prognostic relevance of disseminated tumor cells in the bone marrow of patients with ovarian cancer. Int J Gynecol Cancer. 2013;23:839–45.

    Article  PubMed  Google Scholar 

  67. Aktas B, Kasimir-Bauer S, Heubner M, Kimmig R, Wimberger P. Molecular profiling and prognostic relevance of circulating tumor cells in the blood of ovarian cancer patients at primary diagnosis and after platinum-based chemotherapy. Int J Gynecol Cancer. 2011;21:822–30.

    Article  PubMed  Google Scholar 

  68. Ponomarev AV, Shubina IZ. Insights into mechanisms of tumor and immune system interaction: association with wound healing. Front Oncol. 2019;9:1115.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Tai LH, de Souza CT, Belanger S, Ly L, Alkayyal AA, Zhang J, et al. Preventing postoperative metastatic disease by inhibiting surgery-induced dysfunction in natural killer cells. Cancer Res. 2013;73:97–107.

    Article  CAS  PubMed  Google Scholar 

  70. Lauber K, Ernst A, Orth M, Herrmann M, Belka C. Dying cell clearance and its impact on the outcome of tumor radiotherapy. Front Oncol. 2012;2:116.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Armstrong DK, Alvarez RD, Bakkum-Gamez JN, Barroilhet L, Behbakht K, Berchuck A, et al. Ovarian cancer, Version 2.2020, NCCN clinical practice guidelines in oncology. J Natl Compr Cancer Netw. 2021;19:191–226.

    Article  CAS  Google Scholar 

  72. Vergote I, Trope CG, Amant F, Kristensen GB, Ehlen T, Johnson N, et al. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N Engl J Med. 2010;363:943–53.

    Article  CAS  PubMed  Google Scholar 

  73. Kehoe S, Hook J, Nankivell M, Jayson GC, Kitchener H, Lopes T, et al. Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. Lancet. 2015;386:249–57.

    Article  PubMed  Google Scholar 

  74. Mahner S, Heitz F, Salehi S, Reuss A, Guyon F, Du Bois A, et al. TRUST: trial of radical upfront surgical therapy in advanced ovarian cancer (ENGOT ov33/AGO-OVAR OP7). J Clin Oncol. 2025;43:Lba5500–Lba.

    Article  Google Scholar 

  75. Filis P, Mauri D, Markozannes G, Tolia M, Filis N, Tsilidis K. Hyperthermic intraperitoneal chemotherapy (HIPEC) for the management of primary advanced and recurrent ovarian cancer: a systematic review and meta-analysis of randomized trials. ESMO Open. 2022;7:100586.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  76. Della Corte L, Conte C, Palumbo M, Guerra S, Colacurci D, Riemma G, et al. Hyperthermic Intraperitoneal Chemotherapy (HIPEC): new approaches and controversies on the treatment of advanced epithelial ovarian cancer-systematic review and meta-analysis. J Clin Med. 2023;12:7012.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Lei Z, Wang Y, Wang J, Wang K, Tian J, Zhao Y, et al. Evaluation of cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy for stage III epithelial ovarian cancer. JAMA Netw Open. 2020;3:e2013940.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We would like to thank the patients for agreeing to participate in this study.

Funding

This work was supported by the Mildred Scheel Career Center HaTriCS4 (SAJ, KaP, MNH, AL) and University Cancer Center Hamburg (SAJ, JSS).

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Authors and Affiliations

  1. Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Annabelle Lobermeyer, Jenna Sophie Schöllhorn, Paul N. Rademacher, Maximilian C. Wankner, Sandra Lenz, Cornelia Coith, Sabine Riethdorf, Klaus Pantel & Simon A. Joosse

  2. Mildred Scheel Career Center (MSNZ Hamburg), University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Annabelle Lobermeyer, Mina Netkova-Heintzen, Katharina Prieske & Simon A. Joosse

  3. Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, Department of Internal Medicine II, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Piet Sonnemann

  4. Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Anna Jaeger, Leticia Oliveira-Ferrer, Linn Woelber, Barbara Schmalfeldt, Mina Netkova-Heintzen & Katharina Prieske

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  1. Annabelle Lobermeyer
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Contributions

Conceptualization: SAJ, KaP. Data curation: AL, JSS, MNH, PNR, MCW, PS. Formal analysis: AL, SAJ. Funding acquisition: SAJ, KaP. Investigation: AL, JSS, PNR, MCW, MNH, SL, SR, CC, SAJ. Methodology: AL, JSS, PNR, MCW, MNH, SL, SR, CC, SAJ. Project administration: SAJ, MNH, BS, LOF, LW, AJ, JSS, PNR, MCW, AL. Resources: SAJ, KaP, LOF, BS. Software: SAJ, AL. Supervision: SAJ, KaP, AL, BS. Validation: AL, SAJ, JSS, SR. Visualization: AL, SAJ. Writing - original draft: AL, SAJ. Writing - review and editing: AL, JSS, PNR, MCW, SL, CC, PS, AJ, LOF, LW, SR, KPa, BS, MNH, KaP, SAJ.

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Correspondence to Simon A. Joosse.

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Lobermeyer, A., Schöllhorn, J.S., Rademacher, P.N. et al. Pre-operative circulating tumor cells predict worse treatment outcome in patients with high-grade serous ovarian cancer. Oncogene (2026). https://doi.org/10.1038/s41388-026-03747-3

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