Factors Affecting Cytokine Change After Esophagectomy for Esophageal Cancer

Akihiko Okamura, Hiroya Takeuchi, Satoru Matsuda, Masaharu Ogura, Taku Miyasho, Rieko Nakamura, Tsunehiro Takahashi, Norihito Wada, Hirofumi Kawakubo, Yoshiro Saikawa, Yuukou Kitagawa

Research output: Contribution to journalArticle

27 Citations (Scopus)

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.

Original languageEnglish
JournalAnnals of Surgical Oncology
DOIs
Publication statusAccepted/In press - 2015 Jan 9

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Esophagectomy
Esophageal Neoplasms
Cytokines
Enteral Nutrition
Operative Time
Serum
Interleukin-8
Interleukin-6
Multivariate Analysis
Systemic Inflammatory Response Syndrome
Multiple Organ Failure
Acute Lung Injury
Operative Surgical Procedures
Interleukin-10
Immunosuppression
Medical Records
Enzyme-Linked Immunosorbent Assay
Carcinoma
Survival
Mortality

ASJC Scopus subject areas

  • Surgery
  • Oncology

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Factors Affecting Cytokine Change After Esophagectomy for Esophageal Cancer. / Okamura, Akihiko; Takeuchi, Hiroya; Matsuda, Satoru; Ogura, Masaharu; Miyasho, Taku; Nakamura, Rieko; Takahashi, Tsunehiro; Wada, Norihito; Kawakubo, Hirofumi; Saikawa, Yoshiro; Kitagawa, Yuukou.

In: Annals of Surgical Oncology, 09.01.2015.

Research output: Contribution to journalArticle

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author = "Akihiko Okamura and Hiroya Takeuchi and Satoru Matsuda and Masaharu Ogura and Taku Miyasho and Rieko Nakamura and Tsunehiro Takahashi and Norihito Wada and Hirofumi Kawakubo and Yoshiro Saikawa and Yuukou Kitagawa",
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AU - Nakamura, Rieko

AU - Takahashi, Tsunehiro

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AB - 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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