Circulating tumor cells in the central and peripheral venous compartment – assessing hematogenous dissemination after transarterial chemoembolization of hepatocellular carcinoma

Abstract

The aims of this study were to assess the effect of transarterial chemoembolization (TACE) on circulating tumor cells (CTCs) in the peripheral blood and right atrium of patients with HCC and to evaluate whether perioperative shedding of CTCs affects time to progression of HCC. Before and after TACE, peripheral and right atrial blood samples (7.5 mL) were collected from 42 patients with HCC. CTCs were enriched using EpCAM antibody-conjugated magnetic beads. The number of CTCs was 0–30 and 0–54 in peripheral blood before and after TACE, respectively (P=0.166), and 0–65 and 0–98 in the right atrium before and after TACE, respectively (P=0.102). The number of CTCs was significantly different between the two samples both before (P=0.007) and after (P=0.021) TACE. There was no difference in time to progression between patients with and without an increase in the number of CTCs after TACE in either sample (P>0.05 for both). There were more CTCs in right atrial blood than in peripheral blood. The numbers of CTCs in both samples remained unchanged after TACE. Shedding of tumor cells did not affect time to progression of disease in patients with HCC.

Utility of percutaneous radiofrequency ablation alone or combined with transarterial chemoembolization for early hepatocellular carcinoma

“…Anticancer drugs administered during TACE are thought to be washed out immediately, except for Miripla (33), but these drugs are likely to be carried in blood that flows outside subsegments or the entire liver, via the same hemodynamic route used in the dissemination of liver cancer cells. Anticancer drugs may suppress recurrence of micro-level dissemination of cells during TACE that cannot be detected at the macro level (34,35). These observations supported the idea that treatment with TACE in the tumor-bearing zone not only affects the primary lesion, but also suppresses local and ectopic recurrences.…”

Arterial or Venous: Where Are the Circulating Tumor Cells?

“…In contrast only 53% of cases were found positive for CTCs when venous blood with interrogated and CTC counts ranged from 1 to 8 cells. These findings are supported by previous observations that more CTCs were detected in right atrial blood than in peripheral venous blood in patients with hepatocellular carcinoma ( Fang et al, 2014 ). Similarly, CTCs were found at higher number localized to the hepatic portosystemic macrocirculation than in peripheral blood ( Jiao et al, 2009 ).…”

Arterial Blood, Rather Than Venous Blood, is a Better Source for Circulating Melanoma Cells

“…The detection rates of CTC were significantly higher in the right atrium, compared to peripheral venous blood (73.8% versus 52.4%). The number of CTCs were also higher in blood obtained from the right atrium (median 6, interquartile range 15.5), compared to those in peripheral venous blood (median 1, interquartile range 5.5) ( Fang et al, 2014 ). These studies indicate that the lung circulation would be the major determining factor for CTCs in peripheral circulation and the development of systemic metastasis.…”