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01-09-2015 | Thoracic Oncology

Factors Affecting Cytokine Change After Esophagectomy for Esophageal Cancer

Authors: Akihiko Okamura, MD, Hiroya Takeuchi, MD, PhD, Satoru Matsuda, MD, Masaharu Ogura, MD, PhD, Taku Miyasho, PhD, Rieko Nakamura, MD, PhD, Tsunehiro Takahashi, MD, PhD, Norihito Wada, MD, PhD, Hirofumi Kawakubo, MD, PhD, Yoshiro Saikawa, MD, PhD, Yuko Kitagawa, MD, PhD

Published in: Annals of Surgical Oncology | Issue 9/2015

Abstract

Background

Esophagectomy for esophageal cancer is one of the most invasive operative procedures. Surgical stress induces the release of proinflammatory cytokines, and overproduction induces a systemic inflammatory response syndrome, which may lead to acute lung injury and multiple organ dysfunction syndrome. In addition, surgical stress may cause immunosuppression, which may affect not only perioperative mortality but also long-term survival.

Methods

Between 2006 and 2013, levels of perioperative serum cytokines were evaluated in 90 patients who underwent esophagectomy for esophageal carcinoma. The serum interleukin (IL)-6, IL-8, and IL-10 levels were measured by enzyme-linked immunosorbent assays. We reviewed and assessed medical records, including cytokine profiles, and determined the factors affecting postoperative serum cytokine levels.

Results

These cytokine levels peaked on postoperative day 1 and decreased gradually. Of the clinicopathologic factors, a thoracoscopic approach was a significant factor in attenuating IL-6 and IL-8 levels on postoperative day 1 in multivariate analysis, and a longer operative time was a significant factor in increasing these levels. During postoperative days 3–7, the thoracoscopic approach and early enteral nutrition were significant factors in attenuating serum cytokine changes in multivariate analysis, and postoperative infectious complications were significant factors in increasing these levels.

Conclusions

The thoracoscopic approach and early enteral nutrition could attenuate the cytokine change after esophagectomy, and a longer operative time and postoperative infectious complication could increase it. We should undertake strategies to minimize the surgical stress to reduce potential short-term and long-term consequences for patients.

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Title: Factors Affecting Cytokine Change After Esophagectomy for Esophageal Cancer
Authors: Akihiko Okamura, MD
Hiroya Takeuchi, MD, PhD
Satoru Matsuda, MD
Masaharu Ogura, MD, PhD
Taku Miyasho, PhD
Rieko Nakamura, MD, PhD
Tsunehiro Takahashi, MD, PhD
Norihito Wada, MD, PhD
Hirofumi Kawakubo, MD, PhD
Yoshiro Saikawa, MD, PhD
Yuko Kitagawa, MD, PhD
Publication date: 01-09-2015
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue 9/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-014-4348-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Factors Affecting Cytokine Change After Esophagectomy for Esophageal Cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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