Expression of adhesion and tight junction molecules in the liver after surgery

Metastases in CRC patients originate from tumor cells that have disseminated
from the primary tumor, and either spread via the venous circulation, the
lymphatics or directly into the peritoneal cavity. Under physiological
circumstances, the process of metastases formation is highly inefficient, as
disseminated tumor cells have a limited life span and are rapidly eliminated by
the immune system. However, we previously demonstrated in rats that surgery
induces changes in the liver, which enable adhesion of circulating tumor cells.
We therefore hypothesize that surgery creates permissive circumstances for
tumor cells to adhere in the liver and thereby increases chances of metastatic
development.
The goal of the current study is to translate our findings that we obtained in
animal studies to the clinical setting.

To determine whether surgery induces changes in the liver vasculature of
patients with colorectal cancer.

Prospective, observational pilot study.

At the beginning and end of the operation biopsies will be taken from the liver
segment that is resected. As such, the burden associated with participation
consists of sampling 2 liver biopsies in a part of the liver, which is going to
be removed. No extra liver material is sampled. Because sampling is performed
during surgery, patients will not experience additional discomfort. Their
therapy will neither be delayed nor altered and no extra complications are
expected. Taking liver biopsies during either open or laparoscopic abdominal
procedures is a minimal procedure. The additional risk of preoperative or
postoperative bleeding of the puncture sites is minimal, especially considering
that the biopsies are taken in the liver segment that is resected.