caa a22 4500 445335602 CHVBK 20180317142753.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1245/s10434-011-1620-8 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1620-8 Dissemination of Free Cancer Cells from the Gastric Lumen and from Perigastric Lymphovascular Pedicles during Radical Gastric Cancer Surgery [Elektronische Daten] [Tae-Su Han, Seong-Ho Kong, Hyuk-Joon Lee, Hye-Seong Ahn, Keun Hur, Jieun Yu, Woo-Ho Kim, Han-Kwang Yang] Background: Manipulation and improper handling of a tumor during surgery may increase the risk of cancer cell dissemination after a curative gastrectomy. This study investigated the effect of improper handling of lymphovascular pedicles of stomach on tumor spillage during surgical procedure. Methods: Thirty-eight gastric cancer patients were enrolled. Three pairs of wash samples were obtained from each patient: (1) intraperitoneal wash samples obtained before (P0) and after gastrectomy (P1), (2) intragastric wash samples obtained before any manipulation (G0) and just before resection of the stomach (G1), and (3) ex vivo wash samples obtained by rinsing resected stomach with the lymphovascular pedicles closed by clips (S0) or with the pedicles open (S1). Cytologic examination was performed from all washes, and real-time reverse transcriptase-polymerase chain reaction analysis for carcinoembryonic antigen was performed from washes P0, P1, S0, and S1. Results: Cytologic examination detected cancer cells in 34.2% (13 of 38) of G0 samples and in 39.5% (15 of 38) of G1 samples. The rate of conversion from G0-negative to G1-positive increased as T stage increased. Cytologic examination detected cancer cells in 2.6% (1 of 38) of S0 samples and in 13.2% (5 of 38) of S1 samples. The carcinoembryonic antigen mRNA level of the S1 sample was 2-fold greater than that of the S0 sample in 50.0% (7 of 14). Conclusions: Free cancer cells can be released from gastric lumen or lymphovascular pedicles opened during gastric cancer surgery, especially in advanced-stage disease. Care should be taken to minimize spillage from the gastric lumen and lymphovascular pedicles. Society of Surgical Oncology, 2011 Han Tae-Su Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea aut Kong Seong-Ho Department of Surgery, Seoul National University College of Medicine, Seoul, Korea aut Lee Hyuk-Joon Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea aut Ahn Hye-Seong Department of Surgery, Seoul National University College of Medicine, Seoul, Korea aut Hur Keun Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea aut Yu Jieun Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea aut Kim Woo-Ho Department of Surgery, Seoul National University College of Medicine, Seoul, Korea aut Yang Han-Kwang Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea aut Annals of Surgical Oncology Springer-Verlag 18/10(2011-10-01), 2818-2825 1068-9265 18:10<2818 2011 18 10434 https://doi.org/10.1245/s10434-011-1620-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1620-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Han Tae-Su Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Kong Seong-Ho Department of Surgery, Seoul National University College of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Lee Hyuk-Joon Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Ahn Hye-Seong Department of Surgery, Seoul National University College of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Hur Keun Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Yu Jieun Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Kim Woo-Ho Department of Surgery, Seoul National University College of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Yang Han-Kwang Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/10(2011-10-01), 2818-2825 1068-9265 18:10<2818 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer