Tumor cells in blood shed from the surgical field
E. Hansen, N. Wolff, R. Knuechel, J. Ruschoff, F. Hofstaedter and K. Taeger
Department of Anesthesiology, University of Regensburg, Germany.
OBJECTIVES: To analyze blood shed from the surgical field during oncologic
surgery for tumor cells and to assess functional characteristics of these
cells. DESIGN AND PATIENTS: Series of 61 patients with cancer who underwent
surgery for an abdominal, orthopedic, urological, gynecological, or head
and neck malignant tumor, and blinded comparison with 15 patients with
benign diseases undergoing surgery. SETTING: A 500-bed tumor center and a
tertiary care hospital. MAIN OUTCOME MEASURES: Tumor cells were isolated
from intraoperatively salvaged and washed blood by density gradient
centrifugation. They were identified in cytospin specimens by their content
of cytokeratins and nucleolar organizer regions with a sensitivity of 10
cells in 500 mL of blood. Clonogenicity was tested in a cell colony assay;
invasiveness, in Boyden chambers; and tumorigenicity, in nude mice.
RESULTS: In 57 of 61 patients, tumor cells were detected in the blood shed
during oncologic surgery. They demonstrated proliferation capacity,
invasiveness, and tumorigenicity. The total number of tumor cells
identified ranged from 1 x 10(1) to 7 x 10(6), with no close correlation to
the amount of blood loss. Circulating tumor cells were demonstrated in only
26% of these patients and in small numbers. CONCLUSIONS: Malignant cells
identified regularly in the blood shed during tumor surgery and different
from circulating tumor cells are of concern, since at the surgical site
they may cause local tumor recurrence, or in the salvaged blood they may
cause hematogenic metastasis after retransfusion. Therefore, the
contraindication of intraoperative autotransfusion in tumor surgery is
strongly supported, and a review of surgical procedures and adjuvant
therapy may be indicated, as the passage of the identified cells to the
shed blood is yet unknown.
Anemia and Transfusions in Patients Undergoing Surgery for Cancer
Weber et al.
Ann. Surg. Oncol. 2008;15:34-45.
ABSTRACT
| FULL TEXT
Can intra-operative intraperitoneal free cancer cell detection techniques identify patients at higher recurrence risk following curative colorectal cancer resection: a meta-analysis
Rekhraj et al.
Ann. Surg. Oncol. 2008;15:60-68.
ABSTRACT
| FULL TEXT
Surgical Adjuvant Therapy for Colorectal Cancer: Current Approaches and Future Directions
Monga and O'Connell
Ann. Surg. Oncol. 2006;13:1021-1034.
ABSTRACT
| FULL TEXT
The role of the cytoskeleton in differentially regulating pressure-mediated effects on malignant colonocyte focal adhesion signaling and cell adhesion
Thamilselvan and Basson
Carcinogenesis 2005;26:1687-1697.
ABSTRACT
| FULL TEXT
Preoperative Epoetin Alfa in Colorectal Surgery: A Randomized, Controlled Study
Christodoulakis et al.
Ann. Surg. Oncol. 2005;12:718-725.
ABSTRACT
| FULL TEXT
Results of R0 Resection for Colorectal Liver Metastases Associated With Extrahepatic Disease
Elias et al.
Ann. Surg. Oncol. 2004;11:274-280.
ABSTRACT
| FULL TEXT
Detection and Clinical Implications of Early Systemic Tumor Cell Dissemination in Breast Cancer
Pantel et al.
Clin. Cancer Res. 2003;9:6326-6334.
ABSTRACT
| FULL TEXT
Effects of Whole Body Hyperthermia (41.8{degrees}C) on the Frequency of Tumor Cells in the Peripheral Blood of Patients with Advanced Malignancies
Hegewisch-Becker et al.
Clin. Cancer Res. 2003;9:2079-2084.
ABSTRACT
| FULL TEXT
Circulating Tumor Cell Clusters in the Peripheral Blood of Colorectal Cancer Patients
Molnar et al.
Clin. Cancer Res. 2001;7:4080-4085.
ABSTRACT
| FULL TEXT
Detection and Clinical Importance of Micrometastatic Disease
Pantel et al.
JNCI J Natl Cancer Inst 1999;91:1113-1124.
ABSTRACT
| FULL TEXT
Detection of Melanoma Cells in the Blood of Melanoma Patients by Melanoma-inhibitory Activity (MIA) Reverse Transcription-PCR
Muhlbauer et al.
Clin. Cancer Res. 1999;5:1099-1105.
ABSTRACT
| FULL TEXT
