Detection of Circulating Tumor Cells at Surgery and at Follow-Up Assessment to Predict Survival After Two-Stage Liver Resection of Colorectal Liver Metastases

Kristoffer Watten Brudvik, Lars Thomas Seeberg, Harald Hugenschmidt, Anne Renolen, Cecilie Bendigtsen Schirmer, Cathrine Brunborg, Bjørn Atle Bjørnbeth, Elin Borgen, Bjørn Naume, Anne Waage, Gro Wiedswang

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Background: The presence of circulating tumor cells (CTCs) is negatively associated with survival after resection of colorectal liver metastases (CLM). The current study aimed to determine the prognostic value of CTCs and disseminated tumor cells (DTCs) at the time of surgery and the prognostic value of CTCs at follow-up assessment, for patients scheduled to undergo two-stage hepatectomy with portal vein embolization (PVE) for CLM. Methods: Samples were collected at surgery (blood and bone marrow) and at follow-up assessment (blood) for the period 2008 through 2011. In this study, CTCs were detected with the CellSearch system, and DTCs were detected using standard immunocytochemical analysis. Results: Of 24 patients, 18 completed both stages, and no patients were lost to follow-up. The median overall survival (OS) was 37 months, and the median recurrence-free survival (RFS) was 7 months. At surgery, CTCs were found in nine patients (38 %), and their presence was associated with reduced OS (p < 0.001) and RFS (p = 0.006). Follow-up CTC status was available for 11 patients. All eight patients with positive CTC status experienced recurrence. Two of three patients with negative CTC status remained recurrence free. In seven patients (32 %), DTCs were detected but were not associated with OS or RFS. Conclusions: The presence of CTCs at surgery is associated with worse OS and RFS for patients undergoing two-stage hepatectomy with PVE for CLM. Analysis of CTCs should be explored further for their potential to assist in treatment decisions and monitoring for CLM patients.

Original languageEnglish (US)
Pages (from-to)4029-4037
Number of pages9
JournalAnnals of surgical oncology
Volume22
Issue number12
DOIs
StatePublished - Nov 1 2015

ASJC Scopus subject areas

  • Surgery
  • Oncology

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