Detection of CTCs in portal vein was associated with intrahepatic metastases and prognosis in patients with advanced pancreatic cancer

Liu, Xiaoyu; Li, Changyu; Li, Junhao; Yu, Tianzhu; Zhou, Guofeng; Cheng, Jiemin; Li, Guoping; Zhou, Yang; Lou, Wenhui; Xiao-lin, Wang; Gong, Guangming; Liu, Lingxiao; Chen, Yi

doi:10.7150/jca.23989

Cited by 52 publications

(47 citation statements)

References 39 publications

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“…27,34 Elevated portal vein circulating tumor cell counts are indeed associated with occurrence of liver metastases following resection 36 and decreased overall survival for patients with locally advanced PDAC. 37 NAT appears to reduce the circulating tumor cell burden, with a preventive effect on early recurrence. 38 The association between splenic vessel involvement and portal vein circulating tumor cells has not been established yet, and further research is needed to determine its impact on overall survival.…”

Section: Discussionmentioning

confidence: 96%

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Impact of Neoadjuvant Therapy in Resected Pancreatic Ductal Adenocarcinoma of the Pancreatic Body or Tail on Surgical and Oncological Outcome: A Propensity-Score Matched Multicenter Study

et al. 2019

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Background. Several studies have suggested a survival benefit of neoadjuvant therapy (NAT) for pancreatic ductal adenocarcinoma (PDAC) in the pancreatic head. Data concerning NAT for PDAC located in pancreatic body or tail are lacking. Methods. Post hoc analysis of an international multicenter retrospective cohort of distal pancreatectomy for PDAC in 34 centers from 11 countries (2007-2015). Patients who underwent resection after NAT were matched (1:1 ratio), using propensity scores based on baseline characteristics, to patients who underwent upfront resection. Median overall survival was compared using the stratified log-rank test. Results. Among 1236 patients, 136 (11.0%) received NAT, most frequently FOLFIRINOX (25.7%). In total, 94 patients receiving NAT were matched to 94 patients undergoing upfront resection. NAT was associated with less postoperative major morbidity (Clavien-Dindo C 3a, 10.6% vs. 23.4%, P = 0.020) and pancreatic fistula grade B/C (9.6% vs. 21.3%, P = 0.026). NAT did not improve overall survival [27 (95% CI 14-39) versus 31 months (95% CI 19-42), P = 0.277], as compared with upfront resection. In a sensitivity analysis of 251 patients with radiographic tumor involvement of splenic vessels, NAT Mohammed Abu Hilal and Marc G. Besselink share senior authorship.

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Section: Discussionmentioning

confidence: 96%

“…(n = 37, 14.7%) was associated with prolonged overall survival [36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53]) versus 20 months (95% CI [15][16][17][18][19][20][21][22][23][24], P = 0.049], as compared with upfront resection. Conclusion.…”

mentioning

confidence: 99%

Impact of Neoadjuvant Therapy in Resected Pancreatic Ductal Adenocarcinoma of the Pancreatic Body or Tail on Surgical and Oncological Outcome: A Propensity-Score Matched Multicenter Study

et al. 2019

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“…Liu et. al successfully showed EUS-guided portal vein sampling in 29 patients using 20 G needles without any bleeding complications 17 . Levy et.…”

Section: Discussionmentioning

confidence: 99%

“…After access to the portal vein is obtained and negative suction is applied, blood from the portal vein has to travel the length of the echoendoscope. While larger-gauge needles have not been shown to have clotting issues 5 17 , 22 G needles were found to have “slow” aspiration, which was corrected by adding heparin to the collection tubes 18 . Similarly, our results showed that the saline-coated 22 G needle was incapable of obtaining an adequate quantity of portal vein blood to run a CTC enumeration test due to clotting within the needle.…”

Section: Discussionmentioning

confidence: 99%

“…However, current literature is limited in regard to the methodology of collecting portal blood samples with EUS. Only three studies have evaluated EUS-guided portal vein sampling, and each study used different needle sizes including 19-gauge EUS-fine-needle aspiration (FNA) needles, 20-gauge to 21-gauge EUS-FNA needles, and 22-gauge EUS-FNA needles 5 17 18 19 .…”

Section: Introductionmentioning

confidence: 99%

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Feasibility and safety study of 22-gauge endoscopic ultrasound (EUS) needles for portal vein sampling in a swine model

et al. 2020

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Background and study aims Endoscopic ultrasound (EUS) has been used for portal vein sampling in patients with pancreaticobiliary cancers for enumerating circulating tumor cells but is not yet a standard procedure. Further evaluation is needed to refine the methodology. Therefore, we evaluated the feasibility and safety of 19-gauge (19G) versus a 22-gauge (22 G) EUS fine-needle aspiration needles for portal vein sampling in a swine model. Methods Celiotomy was performed on two farm pigs. Portal vein sampling occurred transhepatically. We compared 19 G and 22 G needles coated interiorly with saline, heparin or ethylenediaminetetraacetic acid (EDTA). Small- (10 mL) and large- (25 mL) volume blood collections were evaluated. Two different collection methods were tested: direct-to-vial and suction syringe. A bleeding risk trial for saline-coated 19 G and 22 G needles was performed by puncturing the portal vein 20 times. Persistent bleeding after 3 minutes was considered significant. Results All small-volume collection trials were successful except for 22 G saline-coated needles with direct-to-vial method. All large-volume collection trials were successful when using suction syringe; direct-to-vial method for both 19 G and 22 G needles were unsuccessful. Collection times were shorter for 19 G vs. 22 G needles for both small and large-volume collections (P < 0.05). Collection times for saline-coated 22 G needles were longer compared to heparin/EDTA-coated (P < 0.05). Bleeding occurred in 10 % punctures with 19 G needles compared to 0 % with 22 G needles. Conclusion The results of this animal study demonstrate the feasibility and the safety of using 22 G needles for portal vein sampling and can form the basis for a pilot study in patients.

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Tumor‐proximal liquid biopsy to improve diagnostic and prognostic performances of circulating tumor cells

et al. 2019

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Circulating tumor cell ( CTC ) detection and numeration are becoming part of the common clinical practice, especially for breast, colon, and prostate cancer. However, their paucity in peripheral blood samples is an obstacle for their identification. Several groups have tried to improve CTC recovery rate by developing highly sensitive cellular and molecular detection methods. However, CTC s are still difficult to detect in peripheral blood. Therefore, their recovery rate could be increased by obtaining blood samples from vessels close to the drainage territories of the invaded organ, when the anatomical situation is favorable. This approach has been tested mostly during tumor resection surgery, when the vessels nearest to the tumor are easily accessible. Moreover, radiological (including echo‐guided based and endovascular techniques) and/or endoscopic routes could be utilized to obtain CTC samples close to the tumor in a less invasive way than conventional biopsies. The purpose of this article is to summarize the available knowledge on CTC recovery from blood samples collected close to the tumor (i.e., in vessels located in the drainage area of the primary tumor or metastases). The relevance of such an approach for diagnostic and prognostic evaluations will be discussed, particularly for pancreatic ductal adenocarcinoma, colorectal adenocarcinoma, hepatocellular carcinoma, and non‐small‐cell lung cancer.

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Detection of CTCs in portal vein was associated with intrahepatic metastases and prognosis in patients with advanced pancreatic cancer

Cited by 52 publications

References 39 publications

Impact of Neoadjuvant Therapy in Resected Pancreatic Ductal Adenocarcinoma of the Pancreatic Body or Tail on Surgical and Oncological Outcome: A Propensity-Score Matched Multicenter Study

Impact of Neoadjuvant Therapy in Resected Pancreatic Ductal Adenocarcinoma of the Pancreatic Body or Tail on Surgical and Oncological Outcome: A Propensity-Score Matched Multicenter Study

Feasibility and safety study of 22-gauge endoscopic ultrasound (EUS) needles for portal vein sampling in a swine model

Tumor‐proximal liquid biopsy to improve diagnostic and prognostic performances of circulating tumor cells

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