Detection of hematogenic tumor cell dissemination in patients undergoing resection of liver metastases of colorectal cancer

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Jürgen Weitz - , Heidelberg University  (Author)
  • Moritz Koch - , Heidelberg University  (Author)
  • Peter Kienle - , Heidelberg University  (Author)
  • Andrea Schrödel - , Heidelberg University  (Author)
  • Frank Willeke - , Heidelberg University  (Author)
  • Axel Benner - , German Cancer Research Center (DKFZ) (Author)
  • Thomas Lehnert - , Heidelberg University  (Author)
  • Christian Herfarth - , Heidelberg University  (Author)
  • Magnus Von Knebel Doeberitz - , Heidelberg University  (Author)

Abstract

Objective: To determine the extent of pre- and intraoperative hematogenic tumor cell dissemination in patients undergoing liver resection for metastatic colorectal cancer. Summary Background Data: For patients with hepatic metastases of colorectal cancer, liver resection is the only potentially curative therapy. However, 38% to 53% of patients develop extrahepatic tumor recurrence, probably caused by tumor cells disseminated before or during surgery not detected by current staging systems. Methods: Blood samples harvested before, during, and after surgery from 41 patients and bone marrow samples from 30 patients undergoing resection liver metastases of colorectal cancer were analyzed for disseminated tumor cells using cytokeratin 20 reverse transcriptase-polymerase chain reaction. Results: Tumor cells were detected in the blood samples of 26 of the 41 patients (63.4%). Tumor cells were detected significantly more often during surgery than before or after surgery. Intraoperative tumor cell dissemination was detected in 41.7% of patients undergoing resection two or more liver segments but on 14.3% of patients undergoing resection of one liver segment. Compared with resection of primary colorectal cancer, major liver resection carries an increased risk for intraoperative tumor cell dissemination. Conclusions: Detection of disseminated tumor cells in patients undergoing liver resection for metastases of colorectal cancer using cytokeratin 20 reverse transcriptase- polymerase chain reaction might help to identify patients at high risk for tumor recurrence who may benefit from adjuvant therapy. Major liver resection of metastases leads to frequent intraoperative tumor cell shedding, possibly preventable by alternative surgical strategies.

Details

Original languageEnglish
Pages (from-to)66-72
Number of pages7
JournalAnnals of surgery
Volume232
Issue number1
Publication statusPublished - Jul 2000
Peer-reviewedYes
Externally publishedYes

External IDs

PubMed 10862197

Keywords

Sustainable Development Goals

ASJC Scopus subject areas