title: Portal vein-circulating tumor cells predict liver metastases in patients with resectable pancreatic cancer.
abstract: Pancreatic cancer patients underwent surgical resection often present distant metastases early after surgery. Detection of circulating tumor cells (CTCs) has been correlated to a worse oncological outcome in patients with advanced pancreatic cancer. The objective of this pilot study is to investigate the possible prognostic role of CTCs in patients undergoing surgery for pancreatic cancer. In 20 patients undergoing pancreatic resection, 10 mL blood sample was collected intraoperatively from both systemic circulation (SC) and portal vein (PV). Blood sample was analyzed for CTCs with CellSearch® system. All patients underwent an oncologic follow-up for at least 3 years, quarterly. CTCs were detected in nine (45%) patients: five patients had CTCs in PV only, three patients in both SC and PV, and one patient in SC only. CTC-positive and CTC-negative patients were similar for demographics and cancer stage pattern. No significant differences were found in both overall and disease-free survival between CTC-positive and CTC-negative patients. At 3-year follow-up, portal vein CTC-positive patients presented a higher rate of liver metastases than CTC-negative patients (53 vs. 8%, p = 0.038). CTCs were found in 45% of the patients. No correlation between CTCs and survival was found. The presence of CTCs in portal vein has been associated to higher rate of liver metastases after surgery.
authors.affiliation: Department of Surgery, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Bissolati
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Sandri
authors.forename: Giovanni
authors.initials: G
authors.lastname: Burtulo
authors.forename: Laura
authors.initials: L
authors.lastname: Zorzino
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Balzano
authors.forename: Marco
authors.initials: M
authors.lastname: Braga
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery; D011169:Portal Vein / Q000473:pathology*; D011379:Prognosis