Megan Sulciner, MD
General Surgery Resident, Research Fellow
Anesthesiology, Perioperative and Pain Medicine, Surgery, Therapeutics & Reperfusion Injury
Megan L. Sulciner, Kimmie Ng, William L. Tan, Lauren K. Brais, Chandrajit P. Raut, Charles N. Serhan
Charles N. Serhan
Research Category: Cancer
Background: Resolution of inflammation is the active process of returning to homeostasis after inflammatory insult, mediated by endogenous specialized pro-resolving mediators (SPMs). Failed resolution of inflammation secondary to surgery contributes to tumor recurrence in animal models. We sought to characterize a comprehensive inflammatory profile in patients after primary tumor resection.
Methods: Plasma collected postoperatively from primary resection of stage 3 colon cancer patients was obtained. Mediator levels were quantified via ELISA. Patient characteristics, oncologic outcomes, and surgical outcomes were analyzed.
Results: Of 19 patients included, 9 developed recurrence after primary resection (cohort 1) and 10 did not (cohort 2) at a median follow-up of 3.4 years. Mean plasma SPM resolvin D2 was 73.9 pg/ml in cohort 1 and 206.3 pg/ml in cohort 2 (p=0.04). Mean levels of other SPMs resolvin D1 (90.2 pg/ml v. 103.2 pg/ml), and lipoxin A4 (226.3 pg/ml v. 279.0 pg/ml), and pro-inflammatory leukotriene B4 (32.7 pg/ml v. 29 pg/ml) and CRP (3.6 ug/ml v. 4.7 ug/ml) were similar. Mean interleukin-6 was 8.1 pg/ml in cohort 1 and 0.5 pg/ml in cohort 2 (p=0.36).
Conclusions: Patients with stage 3 colon cancer that recurred after primary resection had lower plasma levels of the SPM resolvin D2. Trends noted with other SPMs and pro-inflammatory mediators need further investigation.
Background: Persistent inflammation after surgical removal of a tumor has been implicated in contributing to cancer recurrence. Markers of inflammation have been correlated with recurrence risk. We sought to characterize a comprehensive inflammatory profile, inclusive of both inflammatory markers and markers that demonstrate the resolution of inflammation, in cancer patients after tumor resection.
Methods: Levels of inflammatory (leukotriene B4, c-reactive protein, interleukin-6) and resolution of inflammation markers (term specialized pro-resolving mediators; resolvin D2, resolving D1, lipoxin A4) were measured in plasma collected postoperatively from patients with stage 3 colon cancer.
Results: Of 19 patients included, 9 patients developed tumor recurrence after primary resection (cohort 1) and 10 did not (cohort 2). The mean level of interleukin-6 was higher in cohort 1, though not statistically significant. The mean level of leukotriene B4 and c-reactive protein were similar between cohorts. Mean level of resolvin D2 was significantly lower in cohort 1 compared to cohort 2. Mean levels of resolvin D1 and lipoxin A4 were similar.
Conclusions: Patients with stage 3 colon cancer that recurred after primary resection had lower plasma levels of a marker that would indicate inflammation has resolved. Trends noted with these mediators need further investigation.