Metastatic efficiency of tumour cells can be impaired by intraoperative cell salvage process: truth or conjecture?

Abstract

The use of salvaged blood in oncological surgery has been a matter of controversy over the years. This is due to the concern of systemic dissemination of reinfused tumour cells. Recent literature, across disciplines, has shed considerable light on its safety in terms of tumour recurrence, progression and overall survival rates. This clinical safety demonstrates the apparent metastatic inefficiency of reinfused tumour cells. The proof of this concept comes from various studies that have shown that salvaged blood has no tumour cells, or has a significantly lower count as compared to the patient's original circulatory tumour load. Recently, we took a step further and found that the tumour cells in the salvaged blood lose the capacity to replicate. In this review, we revisited the safety of salvaged blood from the point of view of metastatic potential. We have presented basic and applied science evidence regarding the innocuous nature of tumour cells that have been subjected to the cell salvage process. The understanding of the metastatic efficiency or the lack of it in tumour cells subjected to salvage process is key to allay the concerns conventionally associated with the use of salvaged blood in tumour surgery. Based on the available literature, we surmise that the prevalent apprehensions on the usage of salvaged blood are ill-founded and further substantiate why tumour cells in the salvaged blood could be regarded as cells with non-metastatic potential.

The role of intra‐operative cell salvage in patient blood management for revision hip arthroplasty: a prospective cohort study

“…The odds of collecting sufficient blood for re-infusion during this procedure were oneseventh of those when revising femoral and acetabular components. The presence of tumour or infection is not a contra-indication for cell salvage at our institution and this is supported by an increasing number of studies [17,18].…”

“…The odds of collecting sufficient blood for re‐infusion during this procedure were one‐seventh of those when revising femoral and acetabular components. The presence of tumour or infection is not a contra‐indication for cell salvage at our institution and this is supported by an increasing number of studies . Instead, revision hip procedures performed for infection are associated with higher blood loss and cell salvage re‐infusion volumes than for aseptic indications.…”

Antimetastatic effects of calycosin on osteosarcoma and the underlying mechanism

“…More importantly, the metastatic neoplasm is considered to hard cure, resulting in high mortality. In medical chemotherapy, the existing drug to treat metastatic tumor is limited clinically, accompanied with poor therapeutic effectiveness and unreckonable drug resistance . Thereby, searching and developing of effective antimetastatic marker and medication of OS is needed in current clinical practice.…”

“…In medical chemotherapy, the existing drug to treat metastatic tumor is limited clinically, accompanied with poor therapeutic effectiveness and unreckonable drug resistance. 27 Thereby, searching and developing of effective antimetastatic marker and medication of OS is needed in current clinical practice. In human study of OS patients, the positive expressions of endogenous PCNA, IκBα, ECT2 mRNAs, and proteins in OS samples were observed, followed by elevated neoplastic MPP2 contents.…”

Sicherheit der maschinellen Autotransfusion in der Tumorchirurgie

“…Da die Vitalität von Tumorzellen im MAT-Erythrozytenkonzentrat nicht zur Metastasenbildung ausreicht [66] und mit der Leukozytendepletion ein alternativer Sicherheitsschritt verfügbar ist, könnte die Bestrahlung als Methode entfallen. Die Bestrahlung der MAT-Konserve erfordert laut der Richtlinie Hämotherapie 2017 eine (aufwendige) Herstellungserlaubnis gemäß § 13 des Arzneimittelgesetzes (AMG, [67]), was vielerorts die Durchführung in der Praxis deutlich erschwert und für die seltene Durchführung der MAT in der Tumorchirurgie maßgeblich ist.…”