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Web End = Ann Surg Oncol (2015) 22:40294037 DOI 10.1245/s10434-015-4482-7
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Web End = ORIGINAL ARTICLE HEPATOBILIARY TUMORS
Detection of Circulating Tumor Cells at Surgery andat Follow-Up Assessment to Predict Survival After Two-Stage Liver Resection of Colorectal Liver Metastases
Kristoffer Watten Brudvik, MD, PhD1,2, Lars Thomas Seeberg, MD2,6, Harald Hugenschmidt, MD2, Anne Renolen, MSc3, Cecilie Bendigtsen Schirmer, MSc3, Cathrine Brunborg, MSc5, Bjrn Atle Bjrnbeth, MD, PhD1,2,Elin Borgen, MD, PhD3, Bjrn Naume, MD, PhD4,7, Anne Waage, MD, PhD1, and Gro Wiedswang, MD, PhD2
1Department of Hepato-Pancreatico-Biliary Surgery, Oslo University Hospital, Oslo, Norway; 2Department of Gastrointestinal Surgery, Oslo University Hospital, Oslo, Norway; 3Department of Pathology, Oslo University Hospital, Oslo, Norway; 4Department of Oncology, Oslo University Hospital, Oslo, Norway; 5Department of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway; 6Department of Gastrointestinal Surgery, Vestfold Hospital Trust, Tnsberg, Norway; 7Institute of Clinical Medicine, University of Oslo, Oslo, Norway
ABSTRACTBackground. 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...