Pancreatic circulating tumor cells: Where are they?

e21037 Background: We previously demonstrated that circulating tumor cell (CTC) numbers in advanced pancreatic carcinoma were low in contrast to other epithelial carcinomas. We hypothesized that pancreatic CTCs may sequest in the liver and conceived a study to explore CTC number in the peripheral and portal circulations of patients undergoing Whipple’s surgery. Methods: Seventeen patients undergoing Whipple’s surgery were recruited prospectively after informed written consent. Blood was collected intra-operatively from the portal vein prior to tumor mobilization and from the peripheral circulation. Paired samples were analysed for CTC number (CellSearch system, Veridex, USA), and M30/M65 biomarkers of cell death. Results: Of 17 patients 6 had cholangiocarcinomas and 11 had pancreatic adenocarcinomas (5 inoperable). CTC number in the portal circulation was consistently higher than in the peripheral circulation. All patients with cholangiocarcinoma had no CTCs in the peripheral circulation but two patients ...