Detection and prognostic impact of disseminated tumor cells in pancreatic carcinoma.
OBJECTIVE
Metastatic disease determines the prognosis of patients with pancreatic cancer. Current routine staging methods often underestimate the tumor stage because they do not include the search for disseminated tumor cells that spread early in different compartments of the body. Immunohistochemical and molecular methods developed recently are able to detect these cells in multiple compartments of the body.


METHODS
The current status of the detection and the prognostic impact of disseminated tumor cells detected in lymph nodes, bone marrow, blood and peritoneal lavage of patients with pancreatic carcinoma are reviewed.


RESULTS
Disseminated tumor cells can be detected in different compartments of the body even in early tumor stages and when a resection of the primary tumor in curative intention was performed. Furthermore, the detection of these cells has importance for the prognosis and therefore will have therapeutic implications. Standardization of the methods is a prerequisite for further studies.


CONCLUSIONS
The detection of disseminated tumor cells should be included into studies to reveal that this increased staging has an prognostic impact and can be useful for therapeutic decisions in patients with pancreatic carcinoma.
Molecular Oncology Research Laboratory, Department for General and Thoracic Surgery, University of Kiel, Germany. ivogel@surgery.uni-kiel.de
Ilka
I
Vogel
Holger
H
Kalthoff
Doris
D
Henne-Bruns
Bernd
B
Kremer
D001853:Bone Marrow / Q000473:pathology; D002277:Carcinoma / Q000473:pathology*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000473:pathology*; D010529:Peritoneal Cavity / Q000473:pathology; D011379:Prognosis; D007507:Therapeutic Irrigation