Open Surgery May Promote Colon Cancer Tumor Burden

A new study suggests there is a difference in the proliferation and migration of colon cancer cells, based on the differential use of open or laparoscopic surgery.

Researchers at the M.D. Anderson Cancer Center (Orlando, FL, USA) reported on the growth of murine colon cancer (CT26) cells injected into animals before an open or laparoscopic surgery. 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 researchers found that tumors harvested from animals who had open surgery averaged 1.46 g (range, 0.51 g to 1.95 g) in weight, while those harvested from laparoscopic cases were an average 0.67 g (range, 0.04 g to 1.49 g). The average tumor volumes were 22.08 mm³ and 7.41 mm³, respectively.

According to the researchers, the results provided evidence that the IL-6 peak is significantly higher in open surgery compared to that in laparoscopic surgery, and that the cancer cells are consequently able to grow more effectively following open surgery. The researchers concluded that higher levels of circulating cytokines produce an environment rich in inflammatory mediators that can affect tumor growth and metastasis. The study was presented at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) world congress of endoscopic surgery, held during April 2010 in National Harbor (MD, USA).

"These data suggest that surgery-induced levels of cytokines may play a crucial role in the in vivo growth of colon cancer,” said lead author and study presenter Heidi Bahna, M.D. "The different effects of open versus laparoscopic surgery on the growth of colon cancer may be important in prognosis for colon cancer patients.”

"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,” commented Makoto Hashizume, M.D., of the Department of Surgery at Kyushu University (Fukuoka, Japan). "We can reduce tumor burden mechanically and through a reduction in the inflammation that occurs simply due to the act of surgery.”

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M.D. Anderson Cancer Center
Kyushu University