Increased growth factor expression after hepatic and pancreatic resection

Area of Science:

• Oncology
• Surgical Oncology
• Regenerative Medicine

Background:

• Surgical removal of primary tumors may enhance residual micrometastasis growth.
• Growth factors like VEGF and HGF are implicated in wound healing and tumor progression.
• Previous studies noted poor liver regeneration after combined hepatectomy and pancreatectomy.

Purpose of the Study:

• To determine serum levels of VEGF and HGF before, during, and after major abdominal surgery.
• To compare growth factor levels after liver resection versus pancreatic resection.
• To investigate the role of growth factors in post-surgical tumor recurrence.

Main Methods:

• Prospective study of 40 patients undergoing hepatopancreatic surgery (20 liver, 20 pancreatic resections).
• Blood samples collected pre-surgery, intra-operatively, and on postoperative days (POD) 1-3, 5, and 10.
• Wound fluid collected on POD 3.
• Enzyme-linked immunosorbent assay (ELISA) used to quantify VEGF165 and HGF concentrations.

Main Results:

• Circulating HGF and VEGF165 levels significantly increased post-hepatectomy and pancreatectomy.
• HGF levels peaked on POD 2 (p<0.01), remaining elevated on POD 1-3.
• VEGF165 levels were significantly elevated on POD 1-5 (p<0.01).
• No significant difference in growth factor levels between liver and pancreatic resection groups.
• Wound fluid HGF and VEGF165 concentrations were approximately 10-fold higher than preoperative serum levels.

Conclusions:

• Hepatopancreatic surgery leads to increased circulating VEGF165 and HGF.
• Elevated postoperative growth factor levels appear to be part of normal wound healing and systemic inflammation.
• The proangiogenic potential of these factors may contribute to accelerated tumor growth in residual micrometastases.