Background: The resolution of inflammation is the active process of returning to homeostasis after inflammation, mediated by endogenous specialized pro-resolving mediators (SPMs). Failed inflammation resolution secondary to surgery has been shown to contribute to tumor recurrence in animal models. This pilot study aims to characterize a comprehensive inflammatory profile, including SPMs, correlated with recurrence.  

Methods: Levels of pro-inflammatory and SPMs were quantified via ELISA from BWH GI biobank plasma of stage 3 colon cancer patients. Patient characteristics, oncologic outcomes, and surgical outcomes were analyzed.

Results: Nineteen patients were included, 9 patients with and 10 patients without recurrence. Median SPM resolvin D2 in patients with recurrence (71.3 pg/ml) compared to those without (133.8 pg/ml) was significant (p=0.04). Median SPM resolvin D1 and lipoxin A₄ levels were 93.7 pg/ml and 242.3 pg/ml, respectively, in patients with recurrence, and 97.7 pg/ml and 206.2 pg/ml in patients without (p=0.39, p=0.35). Median pro-inflammatory interleukin-6 and leukotriene B4 levels were 10.4 pg/ml and 29.5 pg/ml in patients with recurrence, and 2.6 pg/ml and 27.4 pg/ml in patients without (p=0.36, p=0.47).

Conclusions: Patients with recurrence after primary resection demonstrated a trend of increased pro-inflammatory mediators and diminished SPMs, providing a new mechanism that may contribute to recurrence.