Introduction: To clarify frequency of appearance of systemic Circulating tumor cells (CTCs) following surgery for real cell carcinoma and to compare the difference in postoperative CTCs between different surgical procedures, the present study was conducted.
Methods: This prospective, cohort study included 60 consecutive patients who underwent laparoscopic radical nephrectomy (RN) (n=22), laparoscopic partial nephrectomy (PN) (n=19), open RN (n=8), or open PN (n=11). CTCs were measured by the FISHMAN-R® system. CTCs drawn from a peripheral artery were collected just before and immediately after surgery. The number of pre-and postoperative CTCs and the perioperative changes of CTCs were measured for each surgical modality.
Results: There were no significant differences in preoperative CTCs by surgical approach (laparoscopic RN: laparoscopic PN: open RN: open PN=3.4±4.2: 3.4±4.1: 7.7±6.8: 6.0±7.6, P=0.19). The number of postoperative CTCs (laparoscopic RN: laparoscopic PN: open RN: open PN=4.8±3.7: 7.9±9.1: 22.5±26.3: 6.4±6.3, P<0.001) and the perioperative change of CTCs (laparoscopic RN: laparoscopic PN: open RN: open PN=1.3±5.3: 4.5±9.6: 14.7±25.0: 0.4±6.3, P<0.001) were significantly greater in open RN. No significant differences in these were observed among the three groups except in open RN. Surgical approach was significantly correlated with the number of postoperative CTCs (P=0.0022) and the perioperative change of CTCs (P=0.002) on multivariate analysis.
Conclusions: This proof of concept study indicated that, after surgery, more cancer cells can be expelled into the blood stream, especially following open RN. Sufficient and careful follow-up for the emergence of distant metastases is needed for these patients. Source of
