Hugenschmidt H, Labori KJ, Brunborg C, et al. - Researchers determined how circulating tumor cells (CTCs) can influence the prognosis in patients with presumed resectable pancreatic and periampullary cancers. From 242 patients, blood samples taken before surgery were analyzed. Tumor resection was performed on 179 patients, of those, 30 with stage-I tumors and duodenal cancer were allotted to the low-risk group, and the remaining to the high-risk group. Further 33 showed advanced disease, 30 benign histology. The median cancer-specific survival (CSS) for CTC-positive vs CTC-negative was estimated to be 8.1 vs 20.0 months and disease-free survival was 4.0 vs 10.5 months, in high-risk patients. In advanced disease, the median CSS was found to be 7.7 months. When corrected for histological type, nodal status, and vascular infiltration, CTC-status continued to be independent in the multivariable analysis. A detrimental outcome was evident in patients testing CTC-positive preoperatively, however, these patients had successful tumor resections. Although the low CTC-rate appeared a limiting factor, high specificity was indicated by the findings. Therefore, it was concluded that guidance regarding treatment decisions may be obtained by the preoperative study of CTCs by this test.