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Systemic cytokine response after emergency and elective surgery for colorectal carcinoma

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

Systemic cytokines (SC) are accepted mediators of host immune response. It is debated if long-term survival is influenced by emergency presentation of colorectal cancer, and the role of immunitary response is still unknown. The aim of this prospective study was to compare the SC response after emergency resection with that after elective resections of colorectal carcinoma.

Materials and methods

One hundred six consecutive subjects with colorectal cancer were submitted to emergency (complete bowel obstruction; EMS, n = 50) or elective resection (ELS, n = 56) of the tumour. Sera were collected before surgery and at appropriate time points afterward and assayed for interleukin-1beta (IL-1β), tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP). Five-year survival was analysed according to Kaplan–Meier test. The Cox proportional hazard model was used for the multivariate analysis.

Results

Pre-operative levels of IL-1β, IL-6 and CRP were statistically higher in the EMS group. Levels of TNF-α were not elevated after surgery and there was no difference between the groups. Five-year survival was significantly lower in the EMS group (p < 0.05).

Conclusions

Immunitary response, as reflected by SC, was better after elective resection than after emergency resection of colorectal carcinoma and this difference may have implication in the long-term survival.

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Authors and Affiliations

  1. Transplant, General and Emergency Surgery Department, St. Orsola-Malpighi University Hospital, Via Massarenti 9, 40138, Bologna, Italy

    Fausto Catena, Luca Ansaloni, Andrea Avanzolini, Salomone Di Saverio, Luigi D’Alessandro & Antonio Pinna

  2. Laboratory Department, St. Orsola-Malpighi University Hospital, Bologna, Italy

    Mario Maldini Casadei

Authors
  1. Fausto Catena
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  2. Luca Ansaloni
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  3. Andrea Avanzolini
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  4. Salomone Di Saverio
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  5. Luigi D’Alessandro
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  6. Mario Maldini Casadei
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  7. Antonio Pinna
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Correspondence to Fausto Catena.

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Catena, F., Ansaloni, L., Avanzolini, A. et al. Systemic cytokine response after emergency and elective surgery for colorectal carcinoma. Int J Colorectal Dis 24, 803–808 (2009). https://doi.org/10.1007/s00384-009-0677-3

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  • DOI: https://doi.org/10.1007/s00384-009-0677-3

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