Abstract
<title>Abstract</title> <p>Background The recurrence of early-stage cervical carcinoma (CC) (about 10%) might be due to disseminated tumor cells. This pilot study aimed to assess perioperative dissemination of circulating tumor cells (CTCs) into peripheral blood during surgery for early-stage CC and evaluate the feasibility of their detection. Methods In this bicentric prospective study, 11 patients undergoing laparoscopic resection of histologically confirmed FIGO stage IA1 to IB2 CC were included. CTCs were enumerated using the CellSearch® system in peripheral blood samples collected (i) preoperatively (T0), (ii) after pneumoperitoneum creation (T1), and (iii) before colpotomy (T2). The primary outcome was perioperative CTC detection (T1 or T2) and secondary outcomes included recurrence-free survival. Results CTCs were detected only peroperatively in 3/11 patients (27.3%; 95% CI: 7.3–60.7). One patient (9.1%) had 2 CTCs detected at T1 and two patients (18.2%) had CTCs detected at T2 (50 and 2 CTCs respectively). Among patients with CTCs, two had an epidermoid carcinoma and one an adenocarcinoma; they had stage IA1, IA2, and IB1 respectively. Histopathological examination of hysterectomy specimens revealed residual tumor in 3/11 patients (27.3%), including one CTC-positive patient. After a median follow-up of three years, one recurrence (9.1%) occurred, in a patient without perioperative CTC detection. Conclusions This pilot study demonstrates the feasibility of CTC detection in peripheral blood during surgery for early-stage CC. The prognostic and therapeutic values of CTCs released during cervical cancer surgery warrant further investigation. Trial Registration: ClinicalTrials.gov, NCT04770090, registered on 25 february 2021.</p>