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Perioperative circulating tumor cells in surgical patients with non-small cell lung cancer: does surgical manipulation dislodge cancer cells thus allowing them to pass into the peripheral blood?

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Abstract

Purpose

We herein evaluated the status of circulating tumor cells (CTC) dislodged from the tumor during surgery in patients who underwent pulmonary resection for non-small cell lung cancer (NSCLC) to assess the clinical implications.

Methods

Tumor cells in the peripheral arterial blood before surgery (Before) and immediately after lung resection (After) and in the blood from the pulmonary vein of the resected lung were detected using a size selective method. The clinicopathological characteristics and the prognosis were then analyzed according to the CTC status: no tumor cells detected (N), single tumor cell or total number less than 4 cells (S), and existence of clustered cells (C).

Results

According to the CTC status, the patients were classified into the following three groups: Before-C and After-C, Group I (n = 6); Before-S or N and After-C, Group II (n = 9); and Before-S or N and After-S or N, Group III (n = 8). Group III showed a high rate of p-stage IA, smaller tumor size, lower CEA level, lower SUVmax level, and a higher relapse-free survival rate than the other groups.

Conclusions

CTCs were detected in patients after undergoing lung resection, some of which may have been dislodged by the surgical procedure. The presence of clustered CTCs after the operation indicated an unfavorable outcome.

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Acknowledgments

The authors thank Dr. Hiroshi Maruyama and Dr. Minako Torii (Department of Pathology, Hoshigaoka Medical Center) for their contributions to the pathological diagnoses. This research was supported by a Grant-in-Aid for Scientific Research [(B) 25293301] from the Japan Ministry of Education, Science, Sports and Culture.

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Authors and Affiliations

  1. Division of General Thoracic Surgery, Hoshigaoka Medical Center, Japan Community Healthcare Organization (JCHO), Hirakata, Japan

    Noriyoshi Sawabata & Takeru Hyakutake

  2. Division of Health Science, Osaka University Graduate School of Medicine, Suita, Japan

    Noriyoshi Sawabata

  3. Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Japan

    Soichiro Funaki, Yasushi Shintani, Ayako Fujiwara & Meinoshin Okumura

Authors
  1. Noriyoshi Sawabata
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  2. Soichiro Funaki
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  3. Takeru Hyakutake
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  4. Yasushi Shintani
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  5. Ayako Fujiwara
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  6. Meinoshin Okumura
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Correspondence to Noriyoshi Sawabata.

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Sawabata, N., Funaki, S., Hyakutake, T. et al. Perioperative circulating tumor cells in surgical patients with non-small cell lung cancer: does surgical manipulation dislodge cancer cells thus allowing them to pass into the peripheral blood?. Surg Today 46, 1402–1409 (2016). https://doi.org/10.1007/s00595-016-1318-4

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  • DOI: https://doi.org/10.1007/s00595-016-1318-4

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