Impact of Immune Response in Short-term and Long-term Outcomes After Minimally Invasive Surgery for Colorectal Liver Metastases: Results From a Randomized Study.
Journal
Surgical laparoscopy, endoscopy & percutaneous techniques
ISSN: 1534-4908
Titre abrégé: Surg Laparosc Endosc Percutan Tech
Pays: United States
ID NLM: 100888751
Informations de publication
Date de publication:
21 Jul 2021
21 Jul 2021
Historique:
received:
07
01
2021
accepted:
07
05
2021
pubmed:
23
7
2021
medline:
15
12
2021
entrez:
22
7
2021
Statut:
epublish
Résumé
The potential benefit related to laparoscopic liver surgery (LLS) for colorectal liver metastases outcomes is not well known. Serum cytokines associated with Th1 (tumor necrosis factor-α) and Th2 [interleukin (IL)-10 and IL-6] phenotypes were measured in 36 patients operated on for colorectal liver metastases by open liver surgery (OLS) and LLS. Measurements were performed at 3 time points: 1 day before surgery, day 3 postoperative, and 1 month postoperative. We compared the postoperative inflammatory response influence between LLS and OLS on long-term outcomes. In both groups, only IL-6 levels on day 3 postoperative were higher than those measured preoperatively and at 1 month. Comparing the tumor necrosis factor-α levels between the LLS and OLS groups, preoperative (7.28 vs. 2.36), day 3 (7.99 vs. 4.08) and 1 month (7.39 vs. 1.99) postoperative levels were higher in the OLS group (P<0.01, <0.01, and <0.01, respectively). In contrast, IL-10 levels were higher in the LLS group preoperatively (7.51 vs. 4.57) and on day 3 postoperative (13.40 vs. 4.57) (P=0.03 and 0.01, respectively). A cut-off IL-6 level of ≥4.41 in the first month was associated with a higher risk of recurrence (logrank=4.8, P=0.02). Both LLS and OLS induce an initial increase in IL-6 that normalizes one month after surgery, showing a similar pattern. In addition, a cut-off IL-6 value of 4.41 pg/mL was established, with a higher concentration at 1 month postoperative possibly related to a higher risk or recurrence.
Sections du résumé
BACKGROUND
BACKGROUND
The potential benefit related to laparoscopic liver surgery (LLS) for colorectal liver metastases outcomes is not well known.
MATERIALS AND METHODS
METHODS
Serum cytokines associated with Th1 (tumor necrosis factor-α) and Th2 [interleukin (IL)-10 and IL-6] phenotypes were measured in 36 patients operated on for colorectal liver metastases by open liver surgery (OLS) and LLS. Measurements were performed at 3 time points: 1 day before surgery, day 3 postoperative, and 1 month postoperative. We compared the postoperative inflammatory response influence between LLS and OLS on long-term outcomes.
RESULTS
RESULTS
In both groups, only IL-6 levels on day 3 postoperative were higher than those measured preoperatively and at 1 month. Comparing the tumor necrosis factor-α levels between the LLS and OLS groups, preoperative (7.28 vs. 2.36), day 3 (7.99 vs. 4.08) and 1 month (7.39 vs. 1.99) postoperative levels were higher in the OLS group (P<0.01, <0.01, and <0.01, respectively). In contrast, IL-10 levels were higher in the LLS group preoperatively (7.51 vs. 4.57) and on day 3 postoperative (13.40 vs. 4.57) (P=0.03 and 0.01, respectively). A cut-off IL-6 level of ≥4.41 in the first month was associated with a higher risk of recurrence (logrank=4.8, P=0.02).
CONCLUSIONS
CONCLUSIONS
Both LLS and OLS induce an initial increase in IL-6 that normalizes one month after surgery, showing a similar pattern. In addition, a cut-off IL-6 value of 4.41 pg/mL was established, with a higher concentration at 1 month postoperative possibly related to a higher risk or recurrence.
Identifiants
pubmed: 34292210
doi: 10.1097/SLE.0000000000000980
pii: 00129689-202112000-00006
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
690-696Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The author declares no conflicts of interest.
Références
Vera R, González-Flores E, Rubio C, et al. Multidisciplinary management of liver metastases in patients with colorectal cancer: a consensus of SEOM, AEC, SEOR, SERVEI, and SEMNIM. Clin Transl Oncol. 2020;22:647–662.
Jia C, Li H, Wen N, et al. Laparoscopic liver resection: a review of current indications and surgical techniques. Hepatobiliary Surg Nutr. 2018;7:277–288.
Gomatos IP, Alevizos L, Kalathaki O, et al. Changes in T-lymphocytes’ viability after laparoscopic versus open cholecystectomy. Int Surg. 2015;100:696–701.
Okholm C, Goetze JP, Svendsen LB, et al. Inflammatory response in laparoscopic vs. open surgery for gastric cancer. Scand J Gastroenterol. 2014;49:1027–1034.
Mari G, Crippa J, Costanzi A, et al. ERAS protocol reduces IL-6 secretion in colorectal laparoscopic surgery: results from a randomized clinical trial. Surg Laparosc Endosc Percutan Tech. 2016;26:444–448.
Sista F, Schietroma M, Santis GD, et al. Systemic inflammation and immune response after laparotomy vs laparoscopy in patients with acute cholecystitis, complicated by peritonitis. World J Gastrointest Surg. 2013;5:73–82.
Karanika S, Karantanos T, Theodoropoulos GE. Immune response after laparoscopic colectomy for cancer: a review. Gastroenterol Rep (Oxf). 2013;1:85–94.
Zhang J-M, An J. Cytokines, inflammation, and pain. Int Anesthesiol Clin. 2007;45:27–37.
Fretland AA, Sokolov A, Postriganova N, et al. Inflammatory response after laparoscopic versus open resection of colorectal liver metastases: data from the Oslo-CoMet trial. Medicine. 2015;94:e1786.
Robles-Campos R, Lopez-Lopez V, Brusadin R, et al. Open versus minimally invasive liver surgery for colorectal liver metastases (LapOpHuva): a prospective randomized controlled trial. Surg Endosc. 2019;33:3926–3936.
Brochner AC, Toft P. Pathophysiology of the systemic inflammatory response after major accidental trauma. Scand J Trauma Resusc Emerg Med. 2009;17:43.
Salim T, Sershen CL, May EE. Investigating the role of TNF-alpha and IFN-gamma activation on the dynamics of iNOS gene expression in LPS stimulated macrophages. PLoS One. 2016;11:e0153289.
Balkwill F. Tumour necrosis factor and cancer. Nat Rev Cancer. 2009;9:361–371.
Zhou Z, Xu MJ, Gao B. Hepatocytes: a key cell type for innate immunity. Cell Mol Immunol. 2016;13:301–315.
Duque P, Garutti I, Terradillos E, et al. Modulation of CCL2 expression by laparoscopic versus open surgery for colorectal cancer surgery. Surg Laparosc Endosc Percutan Tech. 2019;29:101–108.
Ozawa A, Konishi F, Nagai H, et al. Cytokine and hormonal responses in laparoscopic-assisted colectomy and conventional open colectomy. Surg Today. 2000;30:107–111.
Watt DG, McSorley ST, Park JH, et al. A postoperative systemic inflammation score predicts short- and long-term outcomes in patients undergoing surgery for colorectal cancer. Ann Surg Oncol. 2017;24:1100–1109.
Cui M, Gong C, Jiang B, et al. Evaluation of immune responses of gastric cancer patients treated by laparoscopic and open gastrectomy. Med Oncol. 2015;32:253.
Ji T, Li G, Chen J, et al. Distinct role of interleukin-6 and tumor necrosis factor receptor-1 in oval cell- mediated liver regeneration and inflammation-associated hepatocarcinogenesis. Oncotarget. 2016;7:66635–66646.
Wiezer MJ, Meijer C, Vuylsteke R, et al. Is major liver surgery associated with an increased systemic inflammatory response? A prospective comparison of hemihepatectomy and other major abdominal surgery. Liver. 1999;19:220–227.
Burpee SE, Kurian M, Murakame Y, et al. The metabolic and immune response to laparoscopic versus open liver resection. Surg Endosc. 2002;16:899–904.
Kuntz C, Kienle P, Schmeding M, et al. Comparison of laparoscopic versus conventional technique in colonic and liver resection in a tumor-bearing small animal model. Surg Endosc. 2002;16:1175–1181.
Li W, Zhou X, Huang Z, et al. Laparoscopic surgery minimizes the release of circulating tumor cells compared to open surgery for hepatocellular carcinoma. Surg Endosc. 2015;29:3146–3153.
Salgado R, Junius S, Benoy I, et al. Circulating interleukin-6 predicts survival in patients with metastatic breast cancer. Int J Cancer. 2003;103:642–646.
Shimazaki J, Goto Y, Nishida K, et al. In patients with colorectal cancer, preoperative serum interleukin-6 level and granulocyte/lymphocyte ratio are clinically relevant biomarkers of long-term cancer progression. Oncology. 2013;84:356–361.
van den Tol MP, ten Raa S, van Grevenstein WM, et al. The post-surgical inflammatory response provokes enhanced tumour recurrence: a crucial role for neutrophils. Dig Surg. 2007;24:388–394.
Lippitz BE, Harris RA. Cytokine patterns in cancer patients: a review of the correlation between interleukin 6 and prognosis. Oncoimmunology. 2016;5:e1093722.
Misawa T, Shiba H, Usuba T, et al. Systemic inflammatory response syndrome after hand-assisted laparoscopic distal pancreatectomy. Surg Endosc. 2007;21:1446–1449.
Novitsky YW, Czerniach DR, Kaban GK, et al. Immunologic effects of hand-assisted surgery on peritoneal macrophages: comparison to open and standard laparoscopic approaches. Surgery. 2006;139:39–45.
Targarona EM, Gracia E, Garriga J, et al. Prospective randomized trial comparing conventional laparoscopic colectomy with hand-assisted laparoscopic colectomy: applicability, immediate clinical outcome, inflammatory response, and cost. Surg Endosc. 2002;16:234–239.
Wu FP, Sietses C, von Blomberg BM, et al. Systemic and peritoneal inflammatory response after laparoscopic or conventional colon resection in cancer patients: a prospective, randomized trial. Dis Colon Rectum. 2003;46:147–155.
Wang D, Kong Y, Zhong B, et al. Fast-track surgery improves postoperative recovery in patients with gastric cancer: a randomized comparison with conventional postoperative care. J Gastroint Surg. 2010;14:620–627.
Vainer N, Dehlendorff C, Johansen JS. Systematic literature review of IL-6 as a biomarker or treatment target in patients with gastric, bile duct, pancreatic and colorectal cancer. Oncotarget. 2018;9:29820–29841.