Assessment of perioperative stress in colorectal cancer by use of in vitro cell models: a systematic review

Abstract

BackgroundThe perioperative period is important for patient outcome. Colorectal cancer surgery can lead to metastatic disease due to release of disseminated tumor cells and the induction of surgical stress response. To explore the overall effects on surgically-induced changes in serum composition, in vitro model systems are useful.MethodsA systematic search in PubMed and EMBASE was performed to identify studies describing in vitro models used to investigate cancer cell growth/proliferation, cell migration, cell invasion and cell death of serum taken pre- and postoperatively from patients undergoing colorectal tumor resection.ResultsTwo authors (MG and TK) independently reviewed 984 studies and identified five studies, which fulfilled the inclusion criteria. Disagreements were solved by discussion. All studies investigated cell proliferation and cell invasion, whereas three studies investigated cell migration, and only one study investigated cell death/apoptosis. One study investigated postoperative peritoneal infection due to anastomotic leak, one study investigated mode of anesthesia (general anesthesia with volatile or intravenous anesthetics), and one study investigated preoperative intervention with granulocyte macrophage colony stimulating factor (GMCSF). In all studies an increased proliferation, cell migration and invasion was demonstrated after surgery. Anesthetics with propofol and intervention with GMCSF significantly reduced postoperative cell proliferation, whereas peritoneal infection enhanced the invasive capability of tumor cells.ConclusionThis study suggests that in vitro cell models are useful and reliable tools to explore the effect of surgery on colorectal cancer cell proliferation and metastatic ability. The models should therefore be considered as additional tests to investigate the effects of perioperative interventions.

Effects of thoracic epidural anesthesia/analgesia on the stress response, pain relief, hospital stay, and treatment costs of patients with esophageal carcinoma undergoing thoracic surgery

“…Studies focusing on colorectal carcinoma have indicated that stress-inducing factors, such as autoimmune dysfunction, surgical wounds, anesthesia, and postoperative pain, can inhibit cellular immune functions in patients with malignant tumors and thereby promote tumor extension and metastasis. [30–32] Thus, reducing the stress response by optimizing the intraoperative and postoperative management of patients with EC could potentially improve outcomes. Factors likely to contribute to the stress response in patients with EC undergoing open thoracotomy include relatively large surgical wounds and substantial postoperative pain.…”

Effects of Volatile Anesthetics on Proliferation and Viability of SW480 Colon Cancer Cells In Vitro

“…For patients undergoing cancer surgery, the risk for cancer dissemination and metastasis is supposed to be enhanced during the perioperative period (1,2). Cancer cells are released into the circulation due to traumatization of tumor vessels and surgical manipulation of the tumor tissue (3).…”

Systematic Reviews and Quality Appraisal ofIn VitroCancer Studies: Investigation of Current Practice

“…Five reviews (17,24,34,44,46) indicated that the following tools were used without any reported adaptations by review authors: Cochrane risk of bias (55); Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) (59); ToxRTool (61); STROBE (65); Grading of Recommendations, Assessment, Development and Evaluations (GRADE) (58) respectively. Authors of three reviews (20,32,39) adapted or modified validated criteria for use with in vitro studies. These included GRADE (adapted for in vitro) (58); Newcastle-Ottawa quality assessment (adapted) (60), modified Research Triangle Institute (RTI) Item Bank for cross-sectional studies (64).…”