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Is Perioperative Systemic Inflammation the Result of Insufficient Cortisol Production in Patients with Colorectal Cancer?

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Patients with colorectal cancer who have a raised systemic inflammatory response before surgery have been shown to have poorer long-term and short-term outcomes. The presence of an ongoing systemic inflammatory response in these patients may be due to impaired cortisol production. The aim of the present study was to examine the relationship between the perioperative systemic inflammatory response and endogenous cortisol production.

Methods

A prospective study was performed to incorporate the assessment of adrenocortical function using synthetic adrenocorticotrophic hormone, a short Synacthen test, as part of the preoperative assessment of patients undergoing resection for colorectal cancer.

Results

A total of 80 patients underwent short Synacthen testing. There were no significant associations between the baseline, 30 min, or change (both relative and absolute) in cortisol and age (all p > 0.10), sex (all p > 0.10), site (all p > 0.10), TNM stage (all p > 0.10), modified Glasgow prognostic score (all p > 0.10), NLR (all p > 0.10), white cell count (all p > 0.10) or postoperative C-reactive protein concentrations (all p > 0.10).

Conclusions

Impaired cortisol production was uncommon in patients with potentially curable colorectal cancer. The presence of a perioperative systemic inflammatory response was not significantly associated with impaired cortisol production.

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Disclosure

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Academic Unit of Surgery, School of Medicine, University of Glasgow, Royal Infirmary, Glasgow, UK

    Michelle L. Ramanathan MBChB, Campbell S. D. Roxburgh PhD, Graeme J. K. Guthrie MBChB, Paul G. Horgan PhD & Donald C. McMillan PhD

  2. Department of Clinical Biochemistry, Royal Infirmary, Glasgow, UK

    Dinesh Talwar PhD

  3. University Pathology Unit, Southern General Hospital, Glasgow, UK

    Clare Orange Msc

Authors
  1. Michelle L. Ramanathan MBChB
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  2. Campbell S. D. Roxburgh PhD
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  3. Graeme J. K. Guthrie MBChB
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  4. Clare Orange Msc
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  5. Dinesh Talwar PhD
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  6. Paul G. Horgan PhD
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  7. Donald C. McMillan PhD
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Corresponding author

Correspondence to Michelle L. Ramanathan MBChB.

Additional information

Michelle L. Ramanathan and Campbell S. D. Roxburgh contributed equally to this study.

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Ramanathan, M.L., Roxburgh, C.S.D., Guthrie, G.J.K. et al. Is Perioperative Systemic Inflammation the Result of Insufficient Cortisol Production in Patients with Colorectal Cancer?. Ann Surg Oncol 20, 2172–2179 (2013). https://doi.org/10.1245/s10434-013-2943-4

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  • DOI: https://doi.org/10.1245/s10434-013-2943-4

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