Digital Public Defence: Harald Hugenschmidt

MD Harald Hugenschmidt at Institute of Clinical Medicine will be defending the thesis The impact of micrometastasis in presumed resectable pancreatic and periampullary cancers. Circulating tumour cells in the peripheral blood and disseminated tumour cells in the bone marrow as potential tools for risk-assessment before surgery for the degree of PhD (Philosophiae Doctor).

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The public defence will be held as a video conference over Zoom.

The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.

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Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.

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Adjudication committee

  • First opponent: Professor Nikolas H. Stoecklein, Heinrich Heine Universität Düsseldorf, Germany
  • Second opponent: Professor II Oddmund Nordgård, University of Stavanger 
  • Third member and chair of the evaluation committee: Professor Kristin Bjørnland, 
    Institute of Clinical Medicine, University of Oslo

Chair of defence

Professor Emeritus Arild Nesbakken, Institute of Clinical Medicine, University of Oslo

Principal supervisor

Senior consultant Gro Wiedswang, Department of Hepatic, Gastrointestinal and Paediatric Surgery, Oslo University Hospital


Adenocarcinoma of the pancreas, distal bile duct, ampulla of Vater and duodenum are highly agressive cancers. Surgical removal of localised tumours is the only chance for curation. The determination of resectability is currently limited by a lack of reliable biomarkers. The aim of the present work was to explore the impact of the detection of circulating tumour cells (CTCs) or disseminated tumour cells to the bone marrow (DTC) on recurence and survival rates after surgical resection. 

The study population were 242 patients with presumed periampullary cancers. Samples for CTCs and DTCs were taken preoperatively and analysed with the CellSearch® assay. Patients were then followed for up to 10 years after surgery. CTCs were detected in 7% of resected cancer patients. Detection of CTCs was associated with a greatly reduced median cancer specific survival, comparable to the shorter survival times of patients with unresectable tumours. In the subgroup of pancreatic cancer patients, the time to metastatic recurrence was also significantly reduced. The time to the detection of local recurrence was independent of the CTC-status. Results for the concurrent immunocytochemical detection of DTCs with Cytokeratin-antibodies in bone-marrow smears did not correlate with presence of malignant disease, recurrence or survival times.

The results from the present study indicate that CTCs but not DTCs are an infrequent but potent risk factor for metastatic recurrence and impaired survival for patients with presumed resectable pancreatic and periampullary carcinoma. The strong impact on survival suggests clinical utility of the CTC-test despite the relatively low detection rate. 

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Published May 4, 2021 12:46 PM - Last modified May 20, 2021 1:13 PM