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Tumor Cell Seeding During Surgery—Possible Contribution to Metastasis Formations

Department of Experimental Hematology and Oncology, Clinic for Internal Medicine II, Friedrich Schiller University, Jena D-07747, Germany
Cancers 2011, 3(2), 2540-2553;
Received: 1 April 2011 / Revised: 23 May 2011 / Accepted: 26 May 2011 / Published: 8 June 2011
PDF [317 KB, uploaded 8 June 2011]


In spite of optimal local control in breast cancer, distant metastases can develop as a systemic part of this disease. Surgery is suspected to contribute to metastasis formation activating dormant tumor cells. Here we add data that seeding of cells during surgery may add to the risk of metastasis formation. The change in circulating epithelial tumor cells (CETC) was monitored in 66 breast cancer patients operated on with breast conserving surgery or mastectomy and during the further course of the disease, analyzing CETC from unseparated white blood cells stained with FITC-anti-EpCAM. An increase in cell numbers lasting until the start of chemotherapy was observed in about one third of patients. It was more preeminent in patients with low numbers of CETC before surgery and, surprisingly, in patients without involved lymph nodes. Patients with the previously reported behavior—Reincrease in cell numbers during adjuvant chemotherapy and subsequent further increase during maintenance therapy—were at increased risk of relapse. In addition to tumor cells already released during growth of the tumor, cell seeding during surgery may contribute to the early peak of relapses observed after removal of the primary tumor and chemotherapy may only marginally postpone relapse in patients with aggressively growing tumors. View Full-Text
Keywords: surgery; tumor cell dissemination; monitoring of circulating epithelial tumor cells surgery; tumor cell dissemination; monitoring of circulating epithelial tumor cells
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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Katharina, P. Tumor Cell Seeding During Surgery—Possible Contribution to Metastasis Formations. Cancers 2011, 3, 2540-2553.

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