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World J Surg Proced. Mar 28, 2015; 5(1): 75-81
Published online Mar 28, 2015. doi: 10.5412/wjsp.v5.i1.75
Impact of circulating tumor cells in colorectal cancer patients undergoing laparoscopic surgery
Jung-Jyh Hung, Chun-Chi Lin, Shung-Haur Yang, Wei-Shone Chen
Jung-Jyh Hung, Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan
Jung-Jyh Hung, Chun-Chi Lin, Shung-Haur Yang, Wei-Shone Chen, Division of Surgery, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
Chun-Chi Lin, Shung-Haur Yang, Wei-Shone Chen, Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan
Author contributions: All authors contributed to this manscript.
Conflict-of-interest: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Wei-Shone Chen, MD, PhD, Division of Surgery, School of Medicine, National Yang-Ming University, No 201, Sec 2, Shih-Pai Rd 11217, Taipei 112, Taiwan. wschen@vghtpe.gov.tw
Telephone: +886-2-28757499 Fax: +886-2-28732267
Received: September 27, 2014
Peer-review started: September 28, 2014
First decision: November 14, 2014
Revised: December 15, 2014
Accepted: January 9, 2015
Article in press: January 12, 2015
Published online: March 28, 2015
Processing time: 187 Days and 2.4 Hours
Abstract

Laparoscopic surgery has recently been widely used for various benign colorectal diseases as well as colorectal cancer. Although laparoscopic surgery has been shown to be with similar prognostic results for certain groups of colorectal cancer patients. The influence of laparoscopic procedures on the oncologist results, especially free tumor cell spreading is still a concern for some surgeons. Tumor cells found in the peripheral blood of patients with cancer are termed circulating tumor cells (CTCs). Presence of CTCs in the peripheral blood of patients with colorectal cancer has been reported to be associated with disease stage, poor prognosis, tumor progression, response to therapy, and drug resistance. Whether laparoscopic procedure enhances tumor spreading during operation remains unknown. Significantly less CTC detected during laparoscopic surgery than open surgery for colorectal cancer has been reported. In our previous experience, no significant elevation in CTC level was found in most patients during laparoscopic resection of colorectal cancer. We have shown that laparoscopic surgery had no significantly deleterious effect on CTCs in colorectal cancer patients. In this review, we aim at the impact of CTCs in patients with colorectal cancer undergoing laparoscopic surgery. The prognostic significance of CTCs in patients with colorectal cancer will also be addressed.

Keywords: Laparoscopic surgery; Circulating tumor cell; Prognosis; Colorectal cancer

Core tip: Although laparoscopic surgery has been widely used for various benign colorectal diseases as well as colorectal cancer, the influence of this procedure on the tumor cell spreading is still unknown. The level of circulating tumor cells (CTCs) in patients with cancer has been reported to be significant prognostic and predictive factors. Whether laparoscopic procedure enhances tumor spreading during operation remains unknown. Significantly less CTC detected during laparoscopic surgery than open surgery for colorectal cancer has been reported. In our previous experience, we have shown that laparoscopic surgery had no significantly deleterious effect on CTCs in colorectal cancer patients.