Recovery of Immunological Homeostasis Positively Correlates Both with Early Stages of Right-Colorectal Cancer and Laparoscopic Surgery

Abstract

Differences in postoperative outcome and recovery between patients subjected to laparoscopic-assisted versus open surgery for colorectal cancer (CRC) resection have been widely documented, though not specifically for right-sided tumors. We investigated the immunological responses to the different surgical approaches, by comparing postoperative data simultaneously obtained at systemic, local and cellular levels. A total of 25 right-sided CRC patients and controls were managed, assessing -in the immediate followup- the conventional perioperative parameters and a large panel of cytokines on plasma, peritoneal fluids and lipopolysaccharide (LPS)-stimulated peripheral blood mononuclear cells (PBMC) tissue cultures. A general better recovery for patients operated with laparoscopy compared to conventional procedure, as indicated by the analysis of typical pre- and post-surgical parameters, was observed. The synchronous evaluation of 12 cytokines showed that preoperative plasma levels of the proinflammatory cytokines IL-6, IL-8, IL-1β, TNFα were significantly lower in healthy donors versus CRC patients and that such differences progressively increase with tumor stage. After surgery, the IL-6 and IL-8 increases were significantly higher in open compared to laparoscopic approach only in CRC at early stages. The postsurgical whole panel of cytokine levels were significantly higher in peritoneal fluids compared to corresponding plasma, but with no significant differences depending on kind of surgery or stage of disease. Then we observed that, pre- compared to the corresponding post-surgery derived LPS-stimulated PBMC cultures, produced higher supernatant levels of the whole cytokine panel. In particular IL-6 in vitro production was significantly higher in PBMC derived from patients subjected to laparoscopic versus open intervention, but -again- only in CRC at early stages of disease. Our results thus show that laparoscopy compared to open right resection is associated with a shorter compromission of the immunological homeostasis, mainly in early stages of right-CRC patients.

Distinct Chemokine Dynamics in Early Postoperative Period after Open and Robotic Colorectal Surgery

“…However, RACS clearly attenuated the up-regulation of IL-8 and MCP-1 and was associated with a drop in RANTES. Findings on reduced inflammatory response also in terms of chemokines corroborate reports of other authors [12,13], although not all [14], on various abdominal MIS. Less accented chemokine up-regulation might be beneficial, as excessive neutrophil and/or monocyte infiltration contributes to postoperative pulmonary complications [15] and postoperative ileus [16,17].…”

Influences of laparoscopic-assisted gastrectomy and open gastrectomy on serum interleukin-6 levels in patients with gastric cancer among Asian populations: a systematic review

“…IL-6 serum levels are positively associated with the severity and the extent of postoperative inflammation, and IL-6 is regarded as a reliable indicator of inflammatory reaction for comparing the efficacies of OG and LAG for treatment of GC [ 7 ]. LAG is associated with lower serum IL-6 levels compared to OG [ 11 ] and the surgery-induced increase in serum IL-6 levels are significantly lower for LAG, compared to the levels induced following OG [ 12 , 13 ]. Apart from the lower serum IL-6 levels, LAG offers the advantages of less blood loss, reduced postoperative complications, shorter hospital stays and accelerated recovery [ 14 ].…”

Cytokines, Fatigue, and Cutaneous Erythema in Early Stage Breast Cancer Patients Receiving Adjuvant Radiation Therapy

“…Cancer-related fatigue is considered as a multidimensional symptom related to the activation of several immunomodulatory pathways due to genetic, psychological, and physiological factors [ 27 ]. Biochemical markers such as systemic inflammatory markers, specific lymphocytic subpopulations, and proinflammatory cytokines have been investigated as factors inducing CRF [ 2 , 4 – 6 , 8 , 9 , 20 , 24 , 27 – 31 ]. In particular, the role of proinflammatory cytokines has been largely studied with contradictory results.…”

“…For simultaneous and serial assessment of plasmatic cytokines, a multiplex biochip array in Evidence Investigator equipment (Randox Labs. Ltd. Crumlin, UK) was used, as previously reported [ 19 , 20 ]. Assays were performed on plasma, following the manufacturer's instructions.…”