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Surgical Endoscopy
Published in: Surgical Endoscopy 7/2011

01-07-2011

Minimally invasive colon resection is associated with a persistent increase in plasma PlGF levels following cancer resection

Authors: H. M. C. Shantha Kumara, Jenny C. Cabot, Xiaohong Yan, Sonali A. C. Herath, Martin Luchtefeld, Matthew F. Kalady, Daniel L. Feingold, Raymond Baxter, Richard L. Whelan

Published in: Surgical Endoscopy | Issue 7/2011

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Abstract

Background

Minimally invasive colorectal resection (MICR) is associated with persistently elevated plasma VEGF levels that may stimulate angiogenesis in residual tumor foci. Placenta growth factor (PlGF) stimulates neovascularization in tumors by modulating VEGF’s effects. This study’s purpose was to determine the impact of MICR on blood PlGF levels in cancer patients (Study A) and to compare PreOp levels in patients with cancer and benign (BEN) disease (Study B).

Methods

Blood samples were collected preoperatively, on postoperative day (POD) 1, POD 3, and at various time points 2–4 weeks after surgery. Samples from 7-day periods after POD 6 were bundled to allow analysis. Plasma PlGF levels were determined via ELISA, results reported as mean ± SD, and data analyzed via t test. Significance was set at p < 0.008 after Bonferroni correction.

Results

Study A: 76 colorectal cancer (CRC) patients had MICR (laparoscopic, 59%; hand-assisted, 41%). The mean length of stay was 5.8 ± 2.1 days. The mean PreOp PlGF level was 15.4 ± 4.3 pg/ml. Significantly increased levels were noted on POD 1 (25.8 ± 7.7 pg/ml, p < 0.001), POD 3 (22.9 ± 6.7, p < 0.001), POD 7–13 (19.2 ± 5.1, p < 0.001), and POD 14–20 (19.5 ± 6.7, p < 0.002). The mean POD 21–27 level was not significantly different from baseline. Study B included 126 CRC and 111 BEN patients. PreOp levels were higher in the CRC patients (15.6 ± 5.3 pg/ml) than in the BEN group (13.5 ± 5.5 pg/ml, p = 0.001).

Conclusions

PlGF levels are elevated for 3 weeks after MICR and PreOp plasma levels are higher in CRC patients than in BEN disease patients. The cause of the postoperative increase is unclear. The persistently higher blood levels of PlGF and VEGF after MICR may stimulate angiogenesis in residual tumor foci. Further studies regarding late blood protein alterations after surgery appear to be indicated.
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Metadata
Title
Minimally invasive colon resection is associated with a persistent increase in plasma PlGF levels following cancer resection
Authors
H. M. C. Shantha Kumara
Jenny C. Cabot
Xiaohong Yan
Sonali A. C. Herath
Martin Luchtefeld
Matthew F. Kalady
Daniel L. Feingold
Raymond Baxter
Richard L. Whelan
Publication date
01-07-2011
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 7/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-010-1514-z

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