Jiangmin Zhou1, Wei Xiao2, Jingjing Yu2, Yani Li2, Ran Tao2, Wang Jinlin1, Chen Xiaoping2 and Zhang Zhiwei1*
1Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China
2Translational Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China
Background: Peripheral blood Circulating Tumor Cells (CTCs) was detected and their prognostic significance was investigated in HCC patients undergoing hepatectomy. Materials and Methods: A total of 137 patients were recruited for the study. The time points for blood collection were one day before the operation, and at 1 month, 2 months after surgery. Preventative adjuvant Transarterial Chemoembolization (TACE) treatment was performed in 26 HCC patients 1 month after liver resection. CTCs were detected by the method of Isolation by Size of Epithelial Tumor cells (ISET). Results: The incidence rate for preoperative CTC detection was 73%. The CTC count in 5 mL of blood ranged between 1 and 45, and the mean and median CTC counts were 4.19 and 5 cells, respectively. The results indicated that a preoperative CTC cut-off value of 5 showed the most significant power to predict recurrence. A preoperative CTC ≥ 5 was an independent risk factor for recurrence (P<0.001). The group of patients receiving hepatectomy and TACE sequential therapy showed a more significant decrease in the ΔCTC count (mean ΔCTC, -1.73 vs. -0.66, P=0.019) and a longer Disease-Free Survival (DFS) (median, 16.4 months vs. 11.4 months) and lower recurrence rates (46.2% vs. 64.9%) than the patients who underwent hepatectomy alone (P=0.036). Conclusion: Preoperative CTC ≥ 5 is a predictor for tumor recurrence after resection. Preventively performing TACE after hepatectomy for those patients with so-called high-risk factors leads to decreased CTC counts and improved DFS.
Zhou J, Xiao W, Yu J, Li Y, Tao R, Jinlin W, et al. Circulating Tumor Cells Predict Prognosis of Patients with Hepatocellular Carcinoma. Clin Surg. 2020; 5: 2911..