Review

Colorectal cancer metastasis: in the surgeon's hands?

Gary Atkin¹ , Abhay Chopada² and Ian Mitchell¹

¹  Department of Surgery, Barnet General Hospital, Wellhouse Lane, Herts, EN5 3DJ, UK

²  Department of Surgery, Ealing Hospital, Uxbridge Rd, Middlesex, UB1 3HW, UK

author email corresponding author email

International Seminars in Surgical Oncology 2005, 2:5doi:10.1186/1477-7800-2-5

Published:	24 February 2005

Abstract

Background

Lymphovascular ligation before tumour manipulation during colorectal cancer resection is termed the 'no-touch isolation' technique. It aims to reduce the intra-operative dissemination of colorectal cancer cells. Recently, the detection of circulating tumour cells has been enhanced by molecular biology techniques. This paper reviews the evidence for the no-touch isolation technique in light of the recent developments in circulating tumour cell detection.

Methods

Studies investigating the effect of colorectal cancer surgery on circulating tumour cells were identified by a Medline search using the subject headings colorectal neoplasms and neoplasm circulating cells together with the map term 'no-touch isolation technique'. Further references were obtained from key articles.

Results

Molecular biological techniques have improved the detection of circulating colorectal cancer cells. There is a trend towards reduced tumour cell dissemination with the no-touch technique compared with the conventional method. However the benefit in terms of improved patient survival remains unproven.

Conclusion

The no-touch isolation technique reduces circulating tumour cell dissemination but further work is needed to determine the significance of this with regards to patient survival.