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

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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.

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Acknowledgment

Kristoffer Watten Brudvik was awarded the Unger-Vetlesen Medical Fund for 2014, and Lars Thomas Seeberg received founding from The Eckbo Foundation, The Finn Wilhelmsen Foundation, and The Blix Family Foundation.

Conflict of interest

There are no conflicts of interest.

Author information

Author notes

    Authors and Affiliations

    1. Department of Hepato-Pancreatico-Biliary Surgery, Oslo University Hospital, Oslo, Norway

      Kristoffer Watten Brudvik MD, PhD, Bjørn Atle Bjørnbeth MD, PhD & Anne Waage MD, PhD

    2. Department of Gastrointestinal Surgery, Oslo University Hospital, Oslo, Norway

      Kristoffer Watten Brudvik MD, PhD, Lars Thomas Seeberg MD, Harald Hugenschmidt MD, Bjørn Atle Bjørnbeth MD, PhD & Gro Wiedswang MD, PhD

    3. Department of Pathology, Oslo University Hospital, Oslo, Norway

      Anne Renolen MSc, Cecilie Bendigtsen Schirmer MSc & Elin Borgen MD, PhD

    4. Department of Oncology, Oslo University Hospital, Oslo, Norway

      Bjørn Naume MD, PhD

    5. Department of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway

      Cathrine Brunborg MSc

    6. Department of Gastrointestinal Surgery, Vestfold Hospital Trust, Tønsberg, Norway

      Lars Thomas Seeberg MD

    7. Institute of Clinical Medicine, University of Oslo, Oslo, Norway

      Bjørn Naume MD, PhD

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    1. Kristoffer Watten Brudvik MD, PhD
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    Correspondence to Kristoffer Watten Brudvik MD, PhD.

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    Kristoffer Watten Brudvik and Lars Thomas Seeberg have contributed equally.

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    Brudvik, K.W., Seeberg, L.T., Hugenschmidt, H. et al. Detection of Circulating Tumor Cells at Surgery and at Follow-Up Assessment to Predict Survival After Two-Stage Liver Resection of Colorectal Liver Metastases. Ann Surg Oncol 22, 4029–4037 (2015). https://doi.org/10.1245/s10434-015-4482-7

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    • DOI: https://doi.org/10.1245/s10434-015-4482-7

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