Unique Localization of Circulating Tumor Cells in Patients With Hepatic Metastases
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Purpose
There are few data on the impact of immediate and differing surgical interventions on circulating tumor
cells (CTCs), nor their compartmentalization or localization in different anatomic vascular sites.
Patients and Methods
CTCs from consecutive patients with colorectal liver metastases were quantified before and
immediately after open surgery, laparoscopic resection, open radiofrequency ablation (RFA), or
percutaneous RFA. For individuals undergoing open surgery, either hepatic resections or open
RFA, CTCs were examined in both systemic and portal circulation by measuring CTCs in samples
derived from the peripheral vein, an artery, the hepatic portal vein, and the hepatic vein.
Results
A total of 29 consecutive patients with colorectal liver metastases with a median age of 55 years
(range, 30 to 88 years) were included. CTCs were localized to the hepatic portosystemic
macrocirculation with significantly greater numbers than in the systemic vasculature. Surgical
procedures led to a statistically significant fall in CTCs at multiple sites measured. Conversely,
RFA, either open or percutaneous, was associated with a significant increase in CTCs.
Conclusion
Surgical resection of metastases, but not RFA, immediately decreases CTC levels. In patients with
colorectal liver metastases, CTCs appear localized to the hepatic (and pulmonary) macrocirculations.
This may explain why metastases in sites other than the liver and lungs are infrequently
observed in cancer.
There are few data on the impact of immediate and differing surgical interventions on circulating tumor
cells (CTCs), nor their compartmentalization or localization in different anatomic vascular sites.
Patients and Methods
CTCs from consecutive patients with colorectal liver metastases were quantified before and
immediately after open surgery, laparoscopic resection, open radiofrequency ablation (RFA), or
percutaneous RFA. For individuals undergoing open surgery, either hepatic resections or open
RFA, CTCs were examined in both systemic and portal circulation by measuring CTCs in samples
derived from the peripheral vein, an artery, the hepatic portal vein, and the hepatic vein.
Results
A total of 29 consecutive patients with colorectal liver metastases with a median age of 55 years
(range, 30 to 88 years) were included. CTCs were localized to the hepatic portosystemic
macrocirculation with significantly greater numbers than in the systemic vasculature. Surgical
procedures led to a statistically significant fall in CTCs at multiple sites measured. Conversely,
RFA, either open or percutaneous, was associated with a significant increase in CTCs.
Conclusion
Surgical resection of metastases, but not RFA, immediately decreases CTC levels. In patients with
colorectal liver metastases, CTCs appear localized to the hepatic (and pulmonary) macrocirculations.
This may explain why metastases in sites other than the liver and lungs are infrequently
observed in cancer.
Date Issued
2009-12-20
Date Acceptance
2009-08-04
Citation
Journal of Clinical Oncology, 2009, 27 (36), pp.6160-6165
ISSN
0732-183X
Publisher
American Society of Clinical Oncology
Start Page
6160
End Page
6165
Journal / Book Title
Journal of Clinical Oncology
Volume
27
Issue
36
Copyright Statement
© 2009 by American Society of Clinical
Oncology
Oncology
Subjects
Science & Technology
Life Sciences & Biomedicine
Oncology
BREAST-CANCER PATIENTS
RADIOFREQUENCY ABLATION
REPORTING RECOMMENDATIONS
PROGNOSTIC-SIGNIFICANCE
SYSTEMIC THERAPY
BONE-MARROW
RESECTION
SURVIVAL
BLOOD
CARCINOMA
Publication Status
Published