Skip to main content

Advertisement

Log in

Enhanced growth of tumour cells in healing colonie anastomoses and laparotomy wounds

  • Original Articles
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

In the past, it has been noted that experimental tumour cells innoculated into the peritoneal cavity or into the lumen of the bowel will grow at a recently formed colonic anastomosis. However, it has previously been unclear whether the healing process enhances tumour growth or whether the presence of a suture line merely allows the tumour cells to gain access to the tissues. In the present study, using the hooded Lister rat, we have confirmed these findings by showing that growth of the syngeneic MC28 sarcoma and OES5 breast carcinoma occurs preferentially at colonic anastomoses and laparotomy wounds after intraperitoneal injection, and at colonic anastomoses after intraluminal injection. In previous studies using the MC28 sarcoma and the OES5 breast carcinoma injected by the intracardiac route (so that tumour cells reach normal and healing tissues in approximately equal numbers) we have shown that tumour growth is enhanced in healing wounds but not in the surrounding normal tissues when cells reach a healing colonic anastomosis or laparotomy wound within 2 h of its formation. Furthermore, by studying the distribution of radiolabelled tumour cells after intracardiac injection, we have calculated that the probability of a tumour cell leading to a deposit in a healing anastomosis or laparotomy wound is increased 1,000 fold compared to normal tissue. No previous studies have combined the data for intracardiac, intraluminal and intraperitoneal injection of tumour cells using the same animal model. We conclude that the same phenomenon of tumour growth enhancement in colonic anastomoses and laparotomy wounds reported after intracardiac injection of tumour cells may well be enhancing tumour growth after intraperitoneal and intraluminal injection. If these results can be extrapolated to man, then tumour cells spilled at surgery for colorectal cancer (or indeed any other cancer) may well encounter an environment which favours their growth and so the healing process itself may contribute to the genesis of local recurrence of malignant disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Phillips RKS, Hittinger R, Blesovsky L, Fry JS, Fielding LP (1984) Local recurrence following “curative” surgery for large bowel cancer: I. The overall picture. Br J Surg 71:12–16

    Google Scholar 

  2. McDermott FT, Hughes ESR, Pihl E, Johnson WR, Price AB (1985) Local recurrence after potentially curative resection for rectal cancer in 1,008 patients. Br J Surg 72:34–37

    Google Scholar 

  3. Hurst PA, Prout WG, Kelly JM, Bannister JJ, Walker RT (1982) Local recurrence after low anterior resection using the staple gun. Br J Surg 69:275–276

    Google Scholar 

  4. Heald RJ, Ryall RDH (1986) Recurrence and survival after total mesorectal excision for rectal cancer. Lancet i:1479–1482

    Google Scholar 

  5. Williams NS (1984) The rationale for preservation of the anal sphincter in patients with low rectal cancer. Br J Surg 71:575–581

    Google Scholar 

  6. Quirke P, Durdey P, Dixon MF, Williams NS (1986) Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision. Lancet ii:996–999

    Google Scholar 

  7. Umpleby HC, Fermor B, Symes MO, Williamson RCN (1984) Viability of exfoliated colorectal carcinoma cells. Br J Surg 71:659–663

    Google Scholar 

  8. Fermor B, Umpleby HC, Lever JV, Symes MO, Williamson RCN (1986) Proliferative and metastatic potential of exfoliated colorectal cancer cells. J Natl Cancer Inst 76:347–349

    Google Scholar 

  9. Skipper D, Cooper AJ, Marston JE, Taylor I (1987) Exfoliated cells and in vitro growth in colorectal cancer. Br J Surg 74:1049–1052

    Google Scholar 

  10. Heald RJ, Husband EM, Ryall RDH (1982) The mesorectum in rectal cancer surgery — the clue to pelvic recurrence? Br J Surg 69:613–616

    Google Scholar 

  11. Jones FS, Rous P (1914) On the cause of the localisation of secondary tumours at points of injury. J Exp Med 20:404–412

    Google Scholar 

  12. Robinson KP, Hoppe E (1962) The development of blood-borne metastases. Effect of local trauma and ischaemia. Arch Surg 85:720–724

    Google Scholar 

  13. Alexander JW, Altemeier WA (1964) Susceptibility of injured tissues to haematogenous metastases; an experimental study. Ann Surg 159:933–944

    Google Scholar 

  14. Fisher ER, Fisher B (1965) Experimental study of factors influencing development of hepatic metastases from circulating tumour cells. Acta Cytol 9:146–158

    Google Scholar 

  15. Murphy P, Alexander P, Senior PV, Fleming J, Kirkham N, Taylor I (1988) Mechanisms of organ selective tumour growth by bloodborne cancer cells. Br J Cancer 57:19–31

    Google Scholar 

  16. Senior PV, Murphy P, Alexander P (1985) Oestrogen dependent rat mammary carcinoma as a model for dormant metastases. In: Hellman K, Ecoles SA (eds) Treatment of metastasis: problems and prospects. Taylor and Francis, London, pp 113–116

    Google Scholar 

  17. Tennant JR (1964) Evaluation of the trypan blue technique for determination of cell viability. Transplantation 2:685–694

    Google Scholar 

  18. Vink M (1954) Local recurrence of cancer in the large bowel: the role of implantation metastases and bowel disinfection. Br J Surg 41:431–433

    Google Scholar 

  19. Cohn I (1967) Implantation in cancer of the colon. Surg Gynecol Obstet 124:501–508

    Google Scholar 

  20. Skipper D, Jeffrey MJ, Cooper AJ, Taylor I, Alexander P (1988) Preferential growth of bloodborne cancer cells in colonie anastomoses. Br J Cancer 57:564–568

    Google Scholar 

  21. Flook D, Horgan K, Taylor BA, Hughes LE (1986) Surgery for malignant melanoma: from which limb should the graft be taken? Br J Surg 73:793–795

    Google Scholar 

  22. Umpleby HC, Williamson RCN (1984) The efficacy of agents employed to prevent anastomotic recurrence in colorectal carcinoma. Ann R Coll Surg Engl 66:192–194

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Skipper, D., Jeffrey, M.J., Cooper, A.J. et al. Enhanced growth of tumour cells in healing colonie anastomoses and laparotomy wounds. Int J Colorect Dis 4, 172–177 (1989). https://doi.org/10.1007/BF01649697

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01649697

Keywords

Navigation