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Perioperative immunomodulation in cancer surgery
T A Colacchio1, M P Yeager, L W Hildebrandt
1Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756.
American Journal of Surgery
|January 1, 1994
Summary
Surgery can suppress the immune system, aiding cancer metastasis. Interleukin-2 (IL-2) and ketorolac reversed this suppression in a mouse model, unlike morphine, which worsened tumor growth.
Area of Science:
- Immunology
- Surgical Oncology
- Pharmacology
Background:
- Colorectal cancer patients often develop metastatic disease despite curative resection.
- Surgery can induce a temporary state of immunosuppression, potentially promoting tumor cell implantation and micrometastasis growth.
Purpose of the Study:
- To evaluate the perioperative modulation of immunocompetence using natural killer cell cytotoxicity (NKCC) and tumor burden.
- To assess the effects of morphine sulfate (MS), ketorolac, and interleukin-2 (IL-2) on immune responses following surgical stress.
Main Methods:
- A murine model was used to measure NKCC and tumor burden.
- Standardized surgical stress (SSS) was administered alone and in combination with MS, ketorolac, or IL-2.
- NKCC and tumor incidence/burden were quantified to assess treatment effects.
Main Results:
- Both IL-2 and ketorolac reversed surgery-induced NKCC suppression.
- Morphine sulfate (MS) further depressed NKCC.
- IL-2 significantly decreased tumor incidence, while MS markedly increased tumor burden post-surgery.
Conclusions:
- IL-2 and ketorolac show potential for restoring perioperative immune competence.
- Continuous morphine use may have detrimental effects on tumor burden after surgery.
- These findings suggest therapeutic strategies to mitigate surgical immunosuppression in cancer patients.