ADVANTAGES LAPAROSCOPIC SURGERY FOR RIGHT COLON CANCER

April 15, 2010 (Landover, Maryland) — New research suggests there is a difference in the proliferation and migration of colon cancer cells based on the use of open or laparoscopic surgery. This question has been a concern for surgeons intent on reducing tumor burden through appropriate surgical intervention.

In research presented here at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 12th World Congress of Endoscopic Surgery, hosted by SAGES and the Canadian Association of General Surgeons, Heidi Bahna, MD, of M.D. Anderson Cancer Center, Orlando, Florida, and colleagues report on the growth of murine colon cancer CT26 cells injected into animals before an open or laparoscopic surgery.

It is known that individuals undergoing open surgery have higher levels of circulating cytokines than those who undergo laparoscopic surgery. The increase in cytokines produces an environment rich in inflammatory mediators that can affect tumor growth and metastasis. The researchers hoped that laparoscopic procedures would decrease cytokine levels, specifically interleukin 6 (IL-6), and that the preservation of normal immune function would create an antitumor environment where cancer cells were unable to thrive.

The results presented during the poster session at the SAGES congress provide evidence that the IL-6 peak is significantly higher in open vs laparoscopic surgery and that cancer cells were able to grow more effectively in animals that had undergone open surgery vs laparoscopic surgery.

Tumors harvested from animals who had open surgery averaged 1.46 g (range, 0.51 – 1.95 g) vs 0.67 g (range, 0.04 – 1.49 g) for laparoscopic cases. Tumors volumes were 22.08 mm3 and 7.41 mm3, respectively.

"These data suggest that surgery-induced levels of cytokines may play a crucial role in the in vivo growth of colon cancer," Dr. Bahna noted. "The different effects of open vs laparoscopic surgery on the growth of colon cancer may be important in prognosis for colon cancer patients."

Makoto Hashizume, MD, from the Department of Surgery at Kyusu University, Fukuoka, Japan, commented, "This research suggests the movement towards laparoscopic surgery for an increasing number of colon surgeries, particularly the right colon, will be helpful from more than one angle. We can reduce tumor burden mechanically and through a reduction in the inflammation that occurs simply due to the act of surgery."

Dr. Bahna and Dr Hashizume have disclosed no relevant financial relationships.

Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 12th World Congress of Endoscopic Surgery: Abstract P014. Presented April 15, 2010.