From the Guidelines
Cancer seeding can be effectively prevented and managed in oncology through the use of minimally invasive techniques, protective barriers, and careful handling of tissues during procedures, as well as prophylactic radiation and adjuvant therapy when necessary. To minimize the risk of tumor seeding, surgeons should employ techniques such as en bloc resection, use wound protectors during laparoscopic surgeries, and consider alternative diagnostic methods to reduce needle tract seeding during biopsies 1. The risk of seeding varies by cancer type, with malignancies like ovarian cancer having a higher seeding potential, thus warranting extra precautions during interventions 1.
When seeding is detected, management typically involves surgical excision of the seeded tumor deposits when possible, followed by adjuvant therapy such as radiation or systemic treatments tailored to the primary cancer type. It is crucial to individualize the approach based on the patient's condition, cancer type, and personal preferences, ensuring that the treatment plan prioritizes morbidity, mortality, and quality of life outcomes.
Key strategies for prevention and management include:
- Using minimally invasive techniques with careful tissue handling
- Employing protective barriers like wound protectors during laparoscopic surgeries
- Considering en bloc resection when appropriate
- Minimizing needle tract seeding during biopsies through coaxial techniques and limiting needle passes
- Considering prophylactic radiation to high-risk areas
- Tailoring adjuvant therapy to the primary cancer type when seeding is detected
These measures are supported by recent guidelines and studies, emphasizing the importance of a multidisciplinary approach to prevent and manage cancer seeding, thereby improving patient outcomes 1.
From the Research
Cancer Seeding Prevention and Management
The fact of cancer seeding is a significant concern in oncology, as it can lead to the spread of cancer cells to other parts of the body. To prevent or manage cancer seeding, it is essential to understand the mechanisms and risks involved.
- Cancer cells can be dislodged from the primary tumor during biopsy or surgical intervention, and can travel to other parts of the body through the bloodstream or lymphatic system 2.
- The risk of tumor cell seeding is higher with certain types of instrumentation, such as laparoscopy and needle biopsy, and with certain primary tumor types, such as carcinomas and adenocarcinomas 3.
- Surgery can contribute to metastasis formation by activating dormant tumor cells and seeding cells during surgery 4.
- The potential for peritoneal cancer cell seeding exists during endoscopic full-thickness resection for early gastric cancer, and a non-exposure approach is recommended to avoid this risk 5.
- Metastases can be seeded by clusters of tumor cells traveling together, rather than single cells, highlighting the importance of considering the collective action of tumor cells in metastatic dissemination 6.
Strategies for Prevention and Management
To prevent or manage cancer seeding, the following strategies can be considered:
- Minimizing the use of instrumentation that can dislodge tumor cells, such as needle biopsy and laparoscopy 3.
- Using a non-exposure approach during endoscopic full-thickness resection for early gastric cancer 5.
- Considering the risk of tumor cell seeding during surgery and taking steps to minimize this risk, such as using careful surgical techniques and avoiding unnecessary manipulation of the tumor 4.
- Developing guidelines and protocols for the prevention and management of cancer seeding, and ensuring that these are followed by healthcare professionals 3.