Does surgery affect certain mediators of thrombocytopoiesis in patients with colorectal cancer?

The most common method to treat colorectal cancer is a surgical procedure involving tumor resection. Surgery induces systemic metabolic changes like hypoxia, acidosis, production of hormones and proinflammatory cytokines, which participate in hematopoiesis.

We examined 38 patients with colorectal cancer and 35 healthy subjects as a control group. In these patients, thrombopoietin concentration, interleukin-6, percentage of reticulated platelets and platelet count were estimated three times: before surgery, 3 days and 12 days after surgery.

In colorectal cancer, before surgery, thrombopoietin, interleukin-6, percentage of reticulated platelets and platelet count were significantly higher than in controls. 3 days after surgery we observed a 2-fold increase in thrombopoietin concentration and a 5-fold increase in interleukin-6 concentration, compared to the baseline. The platelet count was significantly decreased. 12 days after surgery thrombopoietin and interleukin concentration were markedly reduced and platelet count was significantly increased.

Depending on the time that has passed since surgery, we observed significant changes in platelet count and thrombocytopoietic indices. Three days after surgery, platelet count was reduced while concentrations of the cytokines increased, which resulted in a significant rise in platelet count 12 days after surgery. Tumor resection in colorectal cancer patients regulates thrombocytopoiesis and restores physiological relationship between PLT and Tpo. The elevated IL-6 level in our study may indicate its involvement not only in the neoplastic and inflammatory processes, but also in thrombocytopoiesis.