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. 2022 Oct 13;14(20):5004.
doi: 10.3390/cancers14205004.

Intraoperative Extra Corporeal Membrane Oxygenator for Lung Cancer Resections Does Not Impact Circulating Tumor Cells

Francesco Petrella  1   2 , Laura Zorzino  3 , Samuele Frassoni  4 , Vincenzo Bagnardi  4 , Monica Casiraghi  1   2 , Claudia Bardoni  1 , Shehab Mohamed  1 , Valeria Musso  1 , Emanuele Simonini  1 , Fabiana Rossi  5 , Francesco Alamanni  6   7 , Marco Venturino  8 , Lorenzo Spaggiari  1   2
Affiliations

Intraoperative Extra Corporeal Membrane Oxygenator for Lung Cancer Resections Does Not Impact Circulating Tumor Cells

Francesco Petrella et al. Cancers (Basel). .

Abstract

Background: The diagnosis of active neoplastic disease was traditionally judged an absolute contraindication for extracorporeal membrane oxygenator (ECMO) because of the fear of tumor cells being scattered or seeded. The aim of this study is to compare the number of circulating tumor cells (CTCs) before and after surgery in patients receiving lung cancer resection with and without intraoperative ECMO support.

Methods: This is a prospective, non-randomized, two-arms observational study comparing the number of CTCs before and after surgery in patients receiving lung cancer resection with and without intraoperative ECMO support. The ECMO arm includes patients suffering from lung cancer undergoing pulmonary resection with planned intraoperative ECMO support. The non-ECMO arm includes patients suffering from non-early-stage lung cancer undergoing pulmonary resection without planned intraoperative ECMO support.

Results: Twenty patients entered the study, eight in the ECMO arm and twelve in the non-ECMO arm. We did not observe any significant difference between the ECMO and non-ECMO groups in terms of postoperative complications (p = 1.00), ICU stay (p = 0.30), hospital stay (p = 0.23), circulating tumor cells' increase or decrease after surgery (p = 0.24), and postoperative C-reactive protein and C-reactive protein increase (p = 0.80). The procedures in the non-ECMO arm were significantly longer than those in the ECMO arm (p = 0.043).

Conclusions: Intraoperative ECMO for lung cancer resections did not impact CTC increase or decrease after the procedure.

Keywords: circulating tumor cells; extracorporeal membrane oxygenator; lung cancer; lung resection.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
A gallery of images screened for CTCs.
Figure 2
Figure 2
Distribution and individual trajectories of CTCs and CRP pre- and post-op, among patients with and without intraoperative ECMO. Matched box plots showing quantitative changes (pre-op and post-op) of CTCs and CRP in each patient. Half boxes represent the interquartile range and the horizontal bold lines across the boxes indicates the median. Arithmetic means are indicated with the + symbol. The asterisks indicate the values of any data points which lie beyond the extremes of the whiskers (the whiskers extend to the most extreme data point which is no more than 1.5 times the IQR away from the box).
See this image and copyright information in PMC

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