Bacterial Translocation May Influence the Long-Term Survival in Colorectal Cancer Patients

Abstract

Colorectal cancer patients with bacterial translocation in the mesenteric lymph nodes have a worse outcome.

Spillage of bacterial products during colon surgery increases the risk of liver metastases development in a rat colon carcinoma model.

“…39, 40 Since the liver is the first organ receiving blood from the intestines, bacterial components may activate KCs and PMNs and induce ROS production. Patients with positive bacterial translocation after surgery had significantly shorter disease-free survival, 41 supporting the negative impact of bacterial contamination after surgery on oncological outcome. However, the exact role of bacterial translocation in liver metastases development is unknown.…”

“…51, 52 Importantly, a recent study demonstrated that bowel mobilization already led to bacterial translocation in patients. 40 Furthermore, patients with anastomotic leakage or who encountered bacterial translocation after a colectomy had poor disease-free survival, 41 indicating that bacterial contamination had a negative impact on long-term patient outcome. Even though this simplified surgical rat model does not completely reflect the human situation, as multiple peri- and post-operative factors (e.g.…”

Bacterial Translocation and Gut-Derived Sepsis

“…Since then, six additional clinical series totaling 2125 patients undergoing abdominal surgery have shown that the incidence of bacterial translocation ranges from 5% to 21% and that in each of these studies, bacterial translocation was associated with a significant twofold to threefold increase in the rate of septic complications. [15][16][17][18][19][20] Furthermore, in about half of these patients, the same organism was identified in the mesenteric lymph nodes as in the postoperative septic focus. [15][16][17][18][19][20] The notion that the gut was the reservoir for these translocating bacteria has been strengthened further by genomic studies showing that the bacteria in the mesenteric lymph nodes originated from the patients, gut flora.…”

“…[15][16][17][18][19][20] Furthermore, in about half of these patients, the same organism was identified in the mesenteric lymph nodes as in the postoperative septic focus. [15][16][17][18][19][20] The notion that the gut was the reservoir for these translocating bacteria has been strengthened further by genomic studies showing that the bacteria in the mesenteric lymph nodes originated from the patients, gut flora. 21 Thus, several studies of patients undergoing laparotomy have validated the concept that bacterial translocation occurs and that bacterial translocation is associated with a significantly higher incidence of systemic infectious complications in patients undergoing abdominal surgery.…”

“…Based on direct measurements, bacterial translocation undoubtedly does occur in patients undergoing elective and urgent abdominal surgery, and in these patient populations, its occurrence significantly increases the risk for systemic infection. [13][14][15][16][17][18][19][20][21] In other high-risk patients, such as those with severe pancreatitis or cirrhosis, [23][24][25] bacterial translocation also appears to occur and contribute to septic complications. However, direct data supporting bacterial translocation in trauma, [36][37][38][39][40][41][42] burn, and ICU patients are either conflicting or nonexistent.…”