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The influence of surgical trauma on experimental metastasis
S M Murthy1, R A Goldschmidt, L N Rao
1Department of Surgery, Evanston Hospital, Illinois 60201.
Abstract:
Influence of surgical trauma on experimental metastasis in healing wounds is investigated using a transplantable murine mammary carcinoma cell line, TA3Ha. Intravenous injection of 10(5), 10(6), and 2 x 10(6) TA3Ha cells into syngeneic Strain A mice led to liver or kidney tumor development in none of the 96, ten, and ten mice tested, respectively. In contrast, injection of 10(5) cells into mice immediately after hepatic wedge resection performed using milliwatt carbon dioxide laser and electrocautery resulted in tumor formation at the site of trauma in 21/37 (57%) and 25/52 (48%) mice, (P less than 0.001) respectively. Similar results were obtained in mice subjected to partial nephrectomy using the laser (nine of 18) and electrocautery (eight of 13). These results clearly demonstrate that surgical trauma renders a nonprivileged organ susceptible to experimental metastasis formation, and that at least in this model both laser and electrocautery have similar effects. Tumor cell injection 1, 7, and 10 days posthepatic surgery resulted in 36%, 20%, and 0% tumor formation, respectively, indicating that the earlier events in wound healing support tumor implantation and/or growth better than those later on. Frequency of tumor formation at sites of trauma in the peritoneum induced by scalpel blade, laser, and electrocautery were 28%, 50% and 82%, respectively. Peritoneal tumors were seen in 33% of the nonsurgical mice. Skin incisions induced with the three above probes had little influence on experimental metastasis formation. Thus the influence of trauma on tumor formation is not uniform in every organ.
Insights
Surgical trauma significantly increases experimental metastasis in healing wounds, particularly in organs like the liver and kidneys. Early wound healing stages are more susceptible to tumor implantation and growth following surgical procedures.
Area of Science:
- Oncology
- Surgical Research
- Immunology
Background:
- Surgical trauma is a common clinical event that can potentially influence cancer progression.
- The impact of surgical interventions on the body's susceptibility to metastasis requires further investigation.
- Understanding the interplay between wound healing and tumor cell implantation is crucial for patient outcomes.
Purpose of the Study:
- To investigate the influence of surgical trauma on experimental metastasis in healing wounds.
- To compare the effects of different surgical methods (laser, electrocautery, scalpel) on metastasis.
- To determine the temporal relationship between wound healing stages and tumor cell implantation.
Main Methods:
- Utilized a transplantable murine mammary carcinoma cell line (TA3Ha) in syngeneic Strain A mice.
- Administered TA3Ha cells intravenously following various surgical procedures (hepatic wedge resection, partial nephrectomy, peritoneal trauma, skin incisions).
- Assessed tumor formation at trauma sites and in distant organs at different time points post-surgery.
Main Results:
- Surgical trauma, particularly hepatic wedge resection and partial nephrectomy, significantly increased experimental metastasis (57% and 48% tumor formation, respectively).
- Tumor cell injection earlier in the wound healing process (1 day post-surgery) resulted in higher tumor formation (36%) compared to later stages (20% at 7 days, 0% at 10 days).
- Peritoneal trauma induced by laser (50%) and electrocautery (82%) showed a higher incidence of tumor formation compared to scalpel trauma (28%), while skin incisions had minimal influence.
Conclusions:
- Surgical trauma renders non-privileged organs susceptible to experimental metastasis.
- Early stages of wound healing are more conducive to tumor implantation and growth.
- The influence of surgical trauma on metastasis is organ-specific and modality-dependent.