Does lung cancer surgery cause circulating tumor cells?-A multicenter, prospective study.

Area of Science:

• Oncology
• Surgical Oncology
• Cancer Biology

Background:

• Cancer relapse is linked to residual isolated tumor cells (ITCs) post-surgery.
• Surgical manipulation is hypothesized to cause circulating tumor cells (CTCs), the origin of ITCs.
• Previous studies observed CTCs retrospectively in non-small cell lung cancer (NSCLC) patients, but not prospectively.

Purpose of the Study:

• To prospectively investigate the occurrence of CTCs during surgical manipulation in NSCLC patients.
• To determine if surgical procedures increase the presence of CTCs.
• To correlate CTC detection with surgical intervention in lung cancer.

Main Methods:

• A multicenter prospective study involving 29 patients with T1b-2N0M0 lung cancer.
• Blood samples collected pre- and post-lobectomy via peripheral artery access.
• CTCs extracted using a size selection method; detection rates and pathological findings analyzed.

Main Results:

• 24/29 patients had adenocarcinoma, 3/29 squamous cell carcinoma.
• 13 patients were pre-CTCs positive, and 17 were post-CTCs positive.
• Of 16 pre-CTCs negative patients, 4 became post-CTCs positive; all pre-CTCs positive patients remained positive post-surgery.

Conclusions:

• The detection of CTCs post-lung cancer surgery, especially in previously negative patients, indicates CTC dislodgement by surgical manipulation.
• No cases of pre-CTCs positive and post-CTCs negative were observed, supporting the link.
• Findings suggest surgical handling may contribute to the spread of cancer cells during NSCLC procedures.