Perioperative detection of circulating cancer cells in patients with colorectal hepatic metastases.
OBJECTIVE
Surgical resection is the most effective therapy for metastatic colorectal cancer to the liver. However, the selection criteria for patients who may benefit from partial hepatectomy are not fully defined. The aim of this study was to evaluate the usefulness of perioperative molecular detection of circulating cancer cells in predicting clinical outcome in patients with colorectal metastatic liver cancer.


METHODS
Blood samples were obtained perioperatively from the portal vein, peripheral artery, and superior vena cava in 16 consecutive patients with colorectal liver metastases who have undergone partial hepatic resection. We analyzed circulating cancer cells using a carcinoembryonic antigen-specific nested reverse transcriptase-polymerase chain reaction.


RESULTS
Positive carcinoembryonic antigen-mRNA expression was detected in 7 (43.8%) of 16 patients. Six (85.7%) of those 7 patients had hematogenous rerecurrences during the 1- to 3-year follow-up period. None of 9 negative-patients showed re-recurrence (p < 0.01). Among the 9 of 16 patients receiving postoperative adjuvant chemotherapy, no clear effect was noted regarding re-recurrence in the positive carcinoembryonic antigen-mRNA patients.


CONCLUSIONS
These results suggest that the molecular detection of circulating cancer cells at the time of surgery for colorectal liver metastases could be one measure of high-risk patients for hematogenous re-recurrence after partial hepatic resection.
Uchikura
Keiichiro
K
First Department of Surgery, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan. uchi@m.kufm.kagoshima-u.ac.jp
Ueno
Shinichi
S
Takao
Sonshin
S
Miyazono
Futoshi
F
Nakashima
Saburo
S
Tokuda
Koki
K
Nakajo
Akihiro
A
Matsumoto
Masataka
M
Aiko
Takashi
T
D002272:Carcinoembryonic Antigen / Q000097:blood; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local; D009360:Neoplastic Cells, Circulating; D011237:Predictive Value of Tests; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016896:Treatment Outcome
D002272:Carcinoembryonic Antigen