[Perioperative immunomodulatory therapy does not decrease postoperative recurrence rate of rectal cancer]
Zhi-Ming Gan1, Xiao-Dong Wang, Dong-Hao Lv
1West China Medical School/MCQ Group of West China Hospital, Sichuan University, Chengdu 610041, China.
Summary
Perioperative immunomodulatory therapy, including celecoxib and Sou-Medrol, did not significantly alter postoperative recurrence rates in rectal cancer patients. While both agents affected inflammatory markers, neither prevented cancer recurrence in this study.
Area of Science:
- Oncology
- Immunology
- Pharmacology
Background:
- Rectal cancer surgery can lead to postoperative inflammation and recurrence.
- Immunomodulatory therapies are being investigated to mitigate these outcomes.
- Understanding the impact of specific agents on inflammatory markers and recurrence is crucial for treatment optimization.
Purpose of the Study:
- To evaluate the effect of perioperative immunomodulatory therapy on postoperative recurrence of rectal cancer.
- To compare the efficacy of celecoxib and Sou-Medrol against placebo in managing postoperative inflammation and recurrence.
Main Methods:
- A prospective, double-blind, randomized study involving 150 rectal/anal cancer patients undergoing intersphincteric resection.
- Patients received either celecoxib, Sou-Medrol, or placebo daily from 5 days before to 5 days after surgery.
- Postoperative inflammatory markers (C-reactive protein, interleukin-6, COX-2 expression) and cancer recurrence rates were assessed over a mean follow-up of 45 months.
Main Results:
- Significant differences in C-reactive protein (CRP) and interleukin-6 (IL-6) levels were observed postoperatively, with reductions noted in all groups, most notably in the Sou-Medrol and celecoxib groups, respectively.
- Celecoxib demonstrated a significant suppression of COX-2 expression compared to the other groups.
- No statistically significant difference in the postoperative rectal cancer recurrence rate was found among the three treatment groups after a mean follow-up of 45 months.
Conclusions:
- Perioperative immunomodulatory therapy with celecoxib or Sou-Medrol did not reduce the postoperative recurrence rate of rectal cancer.
- Celecoxib showed a greater effect in inhibiting COX-2 expression but was less effective than Sou-Medrol in decreasing postoperative inflammation.
- Further research is needed to identify effective immunomodulatory strategies for preventing rectal cancer recurrence.
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