Circulating tumor and mesenchymal cell release in no-touch radical nephrectomy: a randomized controlled trial

Abstract

Abstract Introduction: Circulating tumor cells (CTCs) may be the missing renal cell carcinoma (RCC) biomarker. Material and Methods: Randomized controlled trial comparing CTC and circulating mesenchymal cell (CMC) release in no-touch (NT) vs. conventional (C) laparoscopic RN. Blood samples were collected at operation room arrival (S0), specimen extraction (S1), postoperative D1, and D30. CTCs isolated and analyzed using the RUBYchip™. Results: 34 patients were randomized from September 2021 to April 2022. No differences were found in CTC and CMC counts, count variations between time points, complications, and outcomes between groups. The total circulating cell detection rates in the NT, C, and overall RCC groups were 58.3%, 80.0%, and 70.4% at S0, 41.6%, 86.7%, and 66.7% at S1, 50.0%, 64.3%, and 60.0% at D1, and 54.5%, 42.9%, and 44.0% at D30, respectively. A progressive decrease in CMCs was observed after surgery in the C group, mainly at D1 (4.78 to 1.64 CMCs/7.5mL-blood, p = 0.035). Healthy controls showed no circulating cells. High CMC counts were found in chronic inflammation controls and oncocytoma patients, not significantly different from RCC patients. Conclusions: NT RN did not reduce circulating cell release nor improve survival.