A distilled water lavage is sometimes used during tumor surgery in an effort to kill tumor cells spilled into a cavity or wound. To test the efficacy of this technique, a model study utilized nine different human tumor cell lines, subjected in v i m to hypotonic exposure for I to 10 minutes. Only the carcinoid, multiple myeloma, leiomyosarcoma cell lines, and normal lymphocytes were destroyed by the treatment. Although breast, ovarian, gastric, bladder, and melanoma cell lines were damaged to varying degrees, viable cells persisted in all cases. These data suggest that hypotonic shock is not an effective method to kill human tumor cells.Cancer 55:2779-2782, 1985.OLE AND COFFEY' reported that cells released from C the tumor margins cut during surgical excision provide a potential seed population for local tumor recurrences. Seeding may be especially troublesome when en bloc excision is not possible. In an effort to destroy such cells, Welsh and Welsh2 have advocated irrigation with warm distilled water on the premise that tumor cells would be lysed by hypotonic shock. In practice, this procedure usually involves filling the affected cavity wound, or hollow organ, with sterile water for I to 2 minutes. Many surgeons continue this practice. Although this procedure may flush cells from the area, no evidence of cell killing has been reported. Controlled evaluation of this technique would seem to be appropriate to establish its efficacy. To this end, we measured the sensitivities of nine human tumor cell lines to osmotic shock in vitro. These cell lines were challenged for I to 10 minutes with distilled water and their subsequent viability and replicative potential were assessed. Materials and Methods Cell LinesNine human tumor cell lines and peripheral lymphocytes from one donor were used. The ovarian (COLO 319), breast (COLO 533N), colon carcinoid (COLO 321), and multiple myeloma (RPMI 8226) cell lines were provided by Dr. George E. Moore, Denver General Hospital. The melanoma (FAMC 113 and I15), leiomyosarcoma (FAMC 151), gastric (FAMC 187), and transitional cell of the bladder (FAMC 191) cell lines were established in this laboratory. Cell lines were screened for contamination and verified as to transformed state and tissue type by karyotype analysis and heterotransplantation. Purified lymphocytes, concentrated over Histopaque (Sigma, St. Louis), were obtained from a healthy donor. All cultures were maintained in antibiotic free GEM 17 17 supplemented with 10% fetal bovine serum. With the exception of the multiple myeloma and normal lymphocytes, all the cell lines grew attached to the plastic substrate.

A distilled water lavage is sometimes used during tumor surgery in an effort to kill tumor cells spilled into a cavity or wound. To test the efficacy of this technique, a model study utilized nine different human tumor cell lines, subjected in vitro to hypotonic exposure for 1 to 10 minutes. Only the carcinoid, multiple myeloma, leiomyosarcoma cell lines, and normal lymphocytes were destroyed by the treatment. Although breast, ovarian, gastric, bladder, and melanoma cell lines were damaged to varying degrees, viable cells persisted in all cases. These data suggest that hypotonic shock is not an effective method to kill human tumor cells.