Annals of Surgical Oncology

, Volume 22, Issue 12, pp 4029–4037 | Cite as

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 BrudvikEmail author
  • Lars Thomas Seeberg
  • Harald Hugenschmidt
  • Anne Renolen
  • Cecilie Bendigtsen Schirmer
  • Cathrine Brunborg
  • Bjørn Atle Bjørnbeth
  • Elin Borgen
  • Bjørn Naume
  • Anne Waage
  • Gro Wiedswang
Hepatobiliary Tumors



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.


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.


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.


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.


Overall Survival Liver Resection Circulate Tumor Cell Colorectal Liver Metastasis Portal Vein Embolization 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



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.


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Copyright information

© Society of Surgical Oncology 2015

Authors and Affiliations

  • Kristoffer Watten Brudvik
    • 1
    • 2
    Email author
  • Lars Thomas Seeberg
    • 2
    • 6
  • Harald Hugenschmidt
    • 2
  • Anne Renolen
    • 3
  • Cecilie Bendigtsen Schirmer
    • 3
  • Cathrine Brunborg
    • 5
  • Bjørn Atle Bjørnbeth
    • 1
    • 2
  • Elin Borgen
    • 3
  • Bjørn Naume
    • 4
    • 7
  • Anne Waage
    • 1
  • Gro Wiedswang
    • 2
  1. 1.Department of Hepato-Pancreatico-Biliary SurgeryOslo University HospitalOsloNorway
  2. 2.Department of Gastrointestinal SurgeryOslo University HospitalOsloNorway
  3. 3.Department of PathologyOslo University HospitalOsloNorway
  4. 4.Department of OncologyOslo University HospitalOsloNorway
  5. 5.Department of Biostatistics and EpidemiologyOslo University HospitalOsloNorway
  6. 6.Department of Gastrointestinal SurgeryVestfold Hospital TrustTønsbergNorway
  7. 7.Institute of Clinical MedicineUniversity of OsloOsloNorway

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