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Laparoscopic surgery minimizes the release of circulating tumor cells compared to open surgery for hepatocellular carcinoma
- Source :
- Surgical endoscopy. 29(11)
- Publication Year :
- 2014
-
Abstract
- The aim of this study was to determine whether tumor manipulation enhances cancer cell release from the primary tumor in HCC patients and which surgical approach, open surgery or laparoscopic resection, is superior with respect to preventing tumor cells from scattering in the blood.A total of 26 HCC patients were prospectively randomized to receive either open surgery (n = 14) or laparoscopic surgery (n = 12). Blood samples were obtained at three time points: preoperative, postoperative, and 24 h after surgery. The CD45(-)/CD44(+)/CD90(+) cells were obtained and counted using quantitative flow cytometry. The serum levels of interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor (TNF-α) were also compared between the two groups.There was no significant difference between the laparoscopic and open groups in terms of patient characteristics. The levels of CCSCs increased immediately after surgical manipulation, and the laparoscopy group released fewer tumor cells into the blood stream. The amount of CCSCs in both groups decreased to reach a similar level 24 h after surgery. Both IL-6 and IL-8 increased after surgery, and the mean postoperative increases in IL-6 and IL-8 serum levels were significantly less in the laparoscopic group than in the open group. The TNF-α levels showed no differences at any time point.Our results showed that patients with laparoscopic surgery have lower IL-6, IL-8 secretion and less CTCs, which may suggest an advantage by restricting CTCs release and a preserved immune response. Further studies are needed to investigate the relationship between the number of CCSCs after surgery and long-term survival rates.
- Subjects :
- Laparoscopic surgery
Adult
Male
medicine.medical_specialty
Carcinoma, Hepatocellular
medicine.medical_treatment
Circulating tumor cell
Internal medicine
medicine
Hepatectomy
Humans
Neoplasm Metastasis
Laparoscopy
Aged
Laparotomy
medicine.diagnostic_test
business.industry
Liver Neoplasms
Hepatology
Middle Aged
medicine.disease
Neoplastic Cells, Circulating
Primary tumor
Surgery
Hepatocellular carcinoma
Cancer cell
Female
business
Abdominal surgery
Subjects
Details
- ISSN :
- 14322218
- Volume :
- 29
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- Surgical endoscopy
- Accession number :
- edsair.doi.dedup.....7e882e9d18d7127ac725f0781ec98f3b