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Published in: Surgery Today 11/2023

22-05-2023 | Mastectomy | Original Article

An observational study of the impact of immediate breast reconstruction on perioperative inflammatory cytokines

Authors: Yuko Mukai, Naruto Taira, Yohei Kitaguchi, Ryoko Nakagiri, Miho Saiga, Mariko Kochi, Takayuki Iwamoto, Tadahiko Shien, Hiroyoshi Doihara, Yoshihiro Kimata

Published in: Surgery Today | Issue 11/2023

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Abstract

Purpose

Perioperative inflammatory cytokines may be related to cancer proliferation, although few studies have investigated this issue in patients undergoing breast reconstruction surgery.

Methods

We conducted a prospective study of patients scheduled for mastectomy only, mastectomy plus deep inferior epigastric perforator flap reconstruction (DIEP), or mastectomy plus tissue expander reconstruction (TE), with or without axial dissection (Ax), for primary breast cancer. Blood samples were collected for analysis of serum IL-6 and VEGF preoperatively, then within 24 h postoperatively (POD 1), and 4–6 days postoperatively (POD 4–6). We investigated the difference in serum cytokine levels over time for each surgical procedure and the difference in serum cytokine levels among the procedures at the three measurement time points.

Results

There were 120 patients included in the final analysis. Serum IL-6 was significantly higher than the preoperative level on POD 1 in patients who underwent mastectomy only, DIEP, or TE and Ax (+), with higher values persisting on POD 4–6 except in those who underwent DIEP. IL-6 was significantly higher after DIEP than after mastectomy only on POD 1, but no differences were observed at POD 4–6. VEGF did not differ significantly among the surgical procedures at any time.

Conclusions

The increase in IL-6 was short term and immediate breast reconstruction is considered a safe procedure.
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Literature
1.
go back to reference Park Y, Kitahara T, Takagi R, Ryoji K. Does surgery for breast cancer induce angiogenesis and thus promote metastasis? Oncology. 2011;81:199–205.CrossRefPubMed Park Y, Kitahara T, Takagi R, Ryoji K. Does surgery for breast cancer induce angiogenesis and thus promote metastasis? Oncology. 2011;81:199–205.CrossRefPubMed
2.
go back to reference Demicheli R, Resky MW, Hrushesky WJM, Baum M, Gukas ID. The effects of surgery on tumor growth: a century of investigations. Ann Oncol. 2008;19:1821–8.CrossRefPubMed Demicheli R, Resky MW, Hrushesky WJM, Baum M, Gukas ID. The effects of surgery on tumor growth: a century of investigations. Ann Oncol. 2008;19:1821–8.CrossRefPubMed
3.
go back to reference Baum M, Demicheli R, Hrushesky W, Retsky M. Does surgery unfavourably perturb the ‘natural history’ of early breast cancer by accelerating the appearance of distant metastases? Eur J Cancer. 2005;41:508–15.CrossRefPubMed Baum M, Demicheli R, Hrushesky W, Retsky M. Does surgery unfavourably perturb the ‘natural history’ of early breast cancer by accelerating the appearance of distant metastases? Eur J Cancer. 2005;41:508–15.CrossRefPubMed
5.
go back to reference Taniguchi K, Karin M. IL-6 and related cytokines as the critical lynchpins between inflammation and cancer. Semin Immunol. 2014;26:54–74.CrossRefPubMed Taniguchi K, Karin M. IL-6 and related cytokines as the critical lynchpins between inflammation and cancer. Semin Immunol. 2014;26:54–74.CrossRefPubMed
6.
go back to reference Knüpfer H, Preiss R. Serum interleukin-6 levels in colorectal cancer patients–a summary of published results. Int J Colorectal Dis. 2010;25:135–40.CrossRefPubMed Knüpfer H, Preiss R. Serum interleukin-6 levels in colorectal cancer patients–a summary of published results. Int J Colorectal Dis. 2010;25:135–40.CrossRefPubMed
7.
go back to reference Gudbrandsdottir G, Aarstad HH, Bostad L, Hjelle KM, Aarstad HJ, Bruserud O, et al. Serum levels of the IL-6 family of cytokines predict prognosis in renal cell carcinoma (RCC). Cancer Immunol Immunother. 2021;70:19–30.CrossRefPubMed Gudbrandsdottir G, Aarstad HH, Bostad L, Hjelle KM, Aarstad HJ, Bruserud O, et al. Serum levels of the IL-6 family of cytokines predict prognosis in renal cell carcinoma (RCC). Cancer Immunol Immunother. 2021;70:19–30.CrossRefPubMed
8.
go back to reference Yokoe T, Morishita Y. Trends of IL-6 and IL-8 levels in patients with recurrent breast cancer: preliminary report. Breast Cancer. 2000;7:187–90.CrossRefPubMed Yokoe T, Morishita Y. Trends of IL-6 and IL-8 levels in patients with recurrent breast cancer: preliminary report. Breast Cancer. 2000;7:187–90.CrossRefPubMed
9.
go back to reference Bozcuk H, Uslu G, Samur M, Yildiz M, Ozben T, Ozdogan M, et al. Tumor necrosis factor-alpha, interleukin-6, and fasting serum insulin correlate with clinical outcome in metastatic breast cancer patients treated with chemotherapy. Cytokine. 2004;27:58–65.CrossRefPubMed Bozcuk H, Uslu G, Samur M, Yildiz M, Ozben T, Ozdogan M, et al. Tumor necrosis factor-alpha, interleukin-6, and fasting serum insulin correlate with clinical outcome in metastatic breast cancer patients treated with chemotherapy. Cytokine. 2004;27:58–65.CrossRefPubMed
10.
go back to reference Melincovici CS, Marginean ABBSSM, Mihu C, Lstrate M, Moldovan LM, Roman AL, et al. Vascular endothelial growth factor (VEGF) – key factor in normal and pathological angiogenesis. Rom J Morphol Embryol. 2018;59:155–67. Melincovici CS, Marginean ABBSSM, Mihu C, Lstrate M, Moldovan LM, Roman AL, et al. Vascular endothelial growth factor (VEGF) – key factor in normal and pathological angiogenesis. Rom J Morphol Embryol. 2018;59:155–67.
11.
go back to reference Salgia R. Prognostic significance of angiogenesis and angiogenic growth factors in non small cell lung cancer. Cancer. 2011;117:3889–99.CrossRefPubMed Salgia R. Prognostic significance of angiogenesis and angiogenic growth factors in non small cell lung cancer. Cancer. 2011;117:3889–99.CrossRefPubMed
12.
go back to reference Kwon KA, Oh SHKSY, Lee S, Han JY, Kim KH, Choi RYGHJ, et al. Clinical significance of preoperative serum vascular endothelial growth factor, interleukin-6, and C-reactive protein level in colorectal cancer. BMC Cancer. 2010;14:203–7.CrossRef Kwon KA, Oh SHKSY, Lee S, Han JY, Kim KH, Choi RYGHJ, et al. Clinical significance of preoperative serum vascular endothelial growth factor, interleukin-6, and C-reactive protein level in colorectal cancer. BMC Cancer. 2010;14:203–7.CrossRef
13.
go back to reference Maniwa Y, Okada M, Ishii N, Kiyooka K. Vascular endothelial growth factor increased by pulmonary surgery accelerates the growth of micrometastases in metastatic lung cancer. Chest. 1998;114:1668–75.CrossRefPubMed Maniwa Y, Okada M, Ishii N, Kiyooka K. Vascular endothelial growth factor increased by pulmonary surgery accelerates the growth of micrometastases in metastatic lung cancer. Chest. 1998;114:1668–75.CrossRefPubMed
14.
go back to reference Hui G, Meng M. Prognostic value of vascular endothelial growth factor expression in women with ovarian cancer: a meta-analysis. J BUON. 2015;20:870–8.PubMed Hui G, Meng M. Prognostic value of vascular endothelial growth factor expression in women with ovarian cancer: a meta-analysis. J BUON. 2015;20:870–8.PubMed
15.
go back to reference Shivakumar S, Prabhakar BT, Jayashree K, Rajan MG, Salimath P. Evaluation of serum vascular endothelial growth factor (VEGF) and microvessel density (MVD) as prognostic indicators in carcinoma breast. J Cancer Res Clin Oncol. 2009;135:627–36.CrossRefPubMed Shivakumar S, Prabhakar BT, Jayashree K, Rajan MG, Salimath P. Evaluation of serum vascular endothelial growth factor (VEGF) and microvessel density (MVD) as prognostic indicators in carcinoma breast. J Cancer Res Clin Oncol. 2009;135:627–36.CrossRefPubMed
16.
go back to reference Sadłecki P, Walentowicz-Sadlecha M, Szymanski W, Grabiec M. Comparison of VEGF, IL-8 and beta-FGF concentrations in the serum and ascites of patients with ovarian cancer. Ginekol Pol. 2011;82:498–502.PubMed Sadłecki P, Walentowicz-Sadlecha M, Szymanski W, Grabiec M. Comparison of VEGF, IL-8 and beta-FGF concentrations in the serum and ascites of patients with ovarian cancer. Ginekol Pol. 2011;82:498–502.PubMed
17.
go back to reference Študent V, Andrýs C, Souček O, Špaček J, Tošner J, Sedláková I, et al. Importance of basal fibroblast growth factor levels in patients with ovarian cancer. Ceska Gynekol. 2018;83:169–76.PubMed Študent V, Andrýs C, Souček O, Špaček J, Tošner J, Sedláková I, et al. Importance of basal fibroblast growth factor levels in patients with ovarian cancer. Ceska Gynekol. 2018;83:169–76.PubMed
18.
go back to reference Takahashi K, Suzuki K, Kawahara S, Ono T. Growth stimulation of human breast epithelial cells by basic fibroblast growth factor in serum-free medium. Int J Cancer. 1989;43:870–4.CrossRefPubMed Takahashi K, Suzuki K, Kawahara S, Ono T. Growth stimulation of human breast epithelial cells by basic fibroblast growth factor in serum-free medium. Int J Cancer. 1989;43:870–4.CrossRefPubMed
19.
go back to reference Gieni M, Avram R, Dickson L, Farrokhyar F, Lovrics P, Faidi S, et al. Local breast cancer recurrence after mastectomy and immediate breast reconstruction for invasive cancer: a meta-analysis. Breast. 2012;21:230–226.CrossRefPubMed Gieni M, Avram R, Dickson L, Farrokhyar F, Lovrics P, Faidi S, et al. Local breast cancer recurrence after mastectomy and immediate breast reconstruction for invasive cancer: a meta-analysis. Breast. 2012;21:230–226.CrossRefPubMed
20.
go back to reference Zhang P, Li CZ, Wu CT, Jiao GM, Yan F, Zhu HC, et al. Comparison of immediate breast reconstruction after mastectomy and mastectomy alone for breast cancer: a meta-analysis. Eur J Surg Oncol. 2017;43:285–93.CrossRefPubMed Zhang P, Li CZ, Wu CT, Jiao GM, Yan F, Zhu HC, et al. Comparison of immediate breast reconstruction after mastectomy and mastectomy alone for breast cancer: a meta-analysis. Eur J Surg Oncol. 2017;43:285–93.CrossRefPubMed
21.
go back to reference Yang X, Zhu C, Gu Y. The prognosis of breast cancer patients after mastectomy and immediate breast reconstruction: a meta-analysis. PLoS One. 2015;10: e0125655.CrossRefPubMedPubMedCentral Yang X, Zhu C, Gu Y. The prognosis of breast cancer patients after mastectomy and immediate breast reconstruction: a meta-analysis. PLoS One. 2015;10: e0125655.CrossRefPubMedPubMedCentral
22.
go back to reference Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6366 patients and results of survey. Ann Surg. 2004;240:205–13.CrossRefPubMedPubMedCentral Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6366 patients and results of survey. Ann Surg. 2004;240:205–13.CrossRefPubMedPubMedCentral
23.
go back to reference Pietrobon AJ, Teixeira FME, Sato MN. Immunosenescence and inflammaging: risk factors of severe COVID-19 in older people. Front Immunol. 2002;27: 579920. Pietrobon AJ, Teixeira FME, Sato MN. Immunosenescence and inflammaging: risk factors of severe COVID-19 in older people. Front Immunol. 2002;27: 579920.
24.
go back to reference Silva MM, Modolin M, Faintuch J, Yamaguchi CM, Zandona CB, Cintra W Jr, et al. Systemic inflammatory reaction after silicone breast implant. Aesthet Plast Surg. 2011;35:789–94.CrossRef Silva MM, Modolin M, Faintuch J, Yamaguchi CM, Zandona CB, Cintra W Jr, et al. Systemic inflammatory reaction after silicone breast implant. Aesthet Plast Surg. 2011;35:789–94.CrossRef
25.
go back to reference Geng Z, Shan WWM, Ren G, Dong C, Ma B. Effect of two short striae incision or traditional “L” shaped incision in neck dissection of differentiated thyroid carcinoma on serum trauma cytokines. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2012;37:1260–4.PubMed Geng Z, Shan WWM, Ren G, Dong C, Ma B. Effect of two short striae incision or traditional “L” shaped incision in neck dissection of differentiated thyroid carcinoma on serum trauma cytokines. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2012;37:1260–4.PubMed
26.
go back to reference Noman AS, Uddin M, Chowdhury AA, Nayeem MJ, Raihan Z, Rashid MI, et al. Serum sonic hedgehog (SHH) and interleukin-(IL-6) as dual prognostic biomarkers in progressive metastatic breast cancer. Sci Rep. 2017;7:1796.CrossRefPubMedPubMedCentral Noman AS, Uddin M, Chowdhury AA, Nayeem MJ, Raihan Z, Rashid MI, et al. Serum sonic hedgehog (SHH) and interleukin-(IL-6) as dual prognostic biomarkers in progressive metastatic breast cancer. Sci Rep. 2017;7:1796.CrossRefPubMedPubMedCentral
27.
go back to reference Zhang L, Ren L, Shan K, Guo X, Wang J, Cui B, et al. Serum inflammatory cytokines comparison in gastric cancer therapy. Open Med (Wars). 2019;12:300–6.CrossRef Zhang L, Ren L, Shan K, Guo X, Wang J, Cui B, et al. Serum inflammatory cytokines comparison in gastric cancer therapy. Open Med (Wars). 2019;12:300–6.CrossRef
28.
go back to reference Curigliano G, Petit JY, Bertolini F, Colleoni M, Peruzzotti G, Braud FD, et al. Systemic effects of surgery: quantitative analysis of circulating basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF), and transforming growth factor beta (TGF-β), in patients with breast cancer who underwent limited or extended surgery. Breast Cancer Res Treat. 2005;93:35–40.CrossRefPubMed Curigliano G, Petit JY, Bertolini F, Colleoni M, Peruzzotti G, Braud FD, et al. Systemic effects of surgery: quantitative analysis of circulating basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF), and transforming growth factor beta (TGF-β), in patients with breast cancer who underwent limited or extended surgery. Breast Cancer Res Treat. 2005;93:35–40.CrossRefPubMed
Metadata
Title
An observational study of the impact of immediate breast reconstruction on perioperative inflammatory cytokines
Authors
Yuko Mukai
Naruto Taira
Yohei Kitaguchi
Ryoko Nakagiri
Miho Saiga
Mariko Kochi
Takayuki Iwamoto
Tadahiko Shien
Hiroyoshi Doihara
Yoshihiro Kimata
Publication date
22-05-2023
Publisher
Springer Nature Singapore
Published in
Surgery Today / Issue 11/2023
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-023-02700-1

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