Does surgical stress cause tumor metastasis?

Area of Science:

• Oncology
• Endocrinology
• Cancer Metastasis Research

Background:

• Surgical stress is a potential factor influencing cancer patient prognosis.
• The hypothesis posits that surgical stress elevates glucocorticoid activity, promoting hematogenous tumor metastasis.

Purpose of the Study:

• To investigate the link between surgical stress, glucocorticoid activity, and tumor metastasis.
• To determine if glucocorticoid excess in cervical cancer patients correlates with metastasis.
• To assess the effect of glucocorticoid excess on tumor metastasis in a murine model.

Main Methods:

• Measured glucocorticosteroid levels in cervical cancer patients undergoing radical surgery.
• Utilized a mouse model with inoculated Ehrlich ascites tumor cells to study metastasis.
• Administered hydrocortisone to mice as a proxy for surgical stress-induced glucocorticoid increase.
• Evaluated the efficacy of cyclophosphamide as adjuvant chemotherapy in conditioned mice.

Main Results:

• Glucocorticoid excess was observed in cancer patients during early postoperative recovery.
• Hydrocortisone pretreatment facilitated lung metastasis of tumor cells in mice.
• Glucocorticoids induced lung capillary constriction and tumor cell surface microvillus growth, aiding metastasis.
• Cyclophosphamide demonstrated efficacy in retarding or arresting tumor metastasis in glucocorticoid-conditioned mice.

Conclusions:

• Surgical stress-induced glucocorticoid excess may enhance blood-borne tumor cell metastasis.
• Glucocorticoid actions on capillary lumen and tumor cell morphology contribute to metastasis.
• Adjuvant chemotherapy with cyclophosphamide may counteract postoperative micrometastasis in the context of glucocorticoid activity.