Systemic Inflammatory Response After Open, Laparoscopic and Robotic Surgery in Endometrial Cancer Patients

Area of Science:

• Oncology
• Surgical Innovation
• Biochemistry

Background:

• Endometrial cancer (EC) treatment involves surgical intervention.
• Understanding the body's response to different surgical techniques is crucial for patient recovery.
• Inflammatory and nutritional status are key indicators of surgical outcomes.

Purpose of the Study:

• To investigate the inflammatory response and nutritional biomarker changes in endometrial cancer patients undergoing different surgical procedures.
• To compare the effects of open laparotomy (LT), laparoscopy (LS), and robot-assisted surgery (RS) on these biomarkers.

Main Methods:

• Prospective analysis of 109 endometrial cancer patients and 24 controls.
• Comparison of pre- and postoperative levels of inflammatory (e.g., CRP, IL-6) and nutritional biomarkers (e.g., vitamins, amino acids).
• Surgical groups included open laparotomy, laparoscopy, and robot-assisted surgery.

Main Results:

• Robot-assisted surgery (RS) demonstrated significantly lower blood loss compared to other methods.
• Inflammatory markers (CRP, IL-6) correlated positively with age, BMI, leukocyte, platelet count, kynurenine, and neopterin, and negatively with vitamin D and retinol.
• Post-surgery, hemoglobin, retinol, alpha-tocopherol, vitamin D, and citrulline decreased, while inflammatory markers increased across all surgical groups to varying extents.

Conclusions:

• Surgical trauma elicits a differential response in endometrial carcinoma patients based on the surgical approach.
• The findings highlight the importance of monitoring inflammatory and nutritional biomarkers in EC patients post-surgery.
• Robot-assisted surgery may offer advantages in minimizing surgical trauma.