title: 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?
abstract: OBJECTIVE
  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.
authors.affiliation: Division of General Thoracic Surgery, Hoshigaoka Medical Center, Japan Community Healthcare Organization (JCHO), Hirakata, Japan. nsawabata@hotmail.com.|Division of Health Science, Osaka University Graduate School of Medicine, Suita, Japan. nsawabata@hotmail.com.
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Sawabata
authors.affiliation: Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Funaki
authors.affiliation: Division of General Thoracic Surgery, Hoshigaoka Medical Center, Japan Community Healthcare Organization (JCHO), Hirakata, Japan.
authors.forename: Takeru
authors.initials: T
authors.lastname: Hyakutake
authors.affiliation: Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shintani
authors.affiliation: Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Fujiwara
authors.affiliation: Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Meinoshin
authors.initials: M
authors.lastname: Okumura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001769:Blood; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D059035:Perioperative Period; D011013:Pneumonectomy / Q000009:adverse effects*; D011379:Prognosis; D011667:Pulmonary Veins; D015996:Survival Rate
keywords: Circulating tumor cells; Lung cancer; Surgery