Inflammatory Response After Laparoscopic Versus Open Resection of Colorectal Liver Metastases: Data From the Oslo-CoMet Trial

• Published in: Medicine (Baltimore) Vol. 94; no. 42; p. e1786
• Main Authors: Fretland, Aasmund Avdem, Sokolov, Andrey, Postriganova, Nadya, Kazaryan, Airazat M., Pischke, Soren E., Nilsson, Per H., Rognes, Ingrid Nygren, Bjornbeth, Bjorn Atle, Fagerland, Morten Wang, Mollnes, Tom Eirik, Edwin, Bjorn
• Format: Journal Article
• Language: English
• Published: United States Wolters Kluwer Health, Inc. All rights reserved 01.10.2015; Lippincott, Williams & Wilkins: Open Access Journals; Wolters Kluwer Health
• Subjects: Aged; C-Reactive Protein - analysis; Chemokine CCL4 - blood; Clinical medical disciplines: 750; Clinical Trial/Experimental Study; Colorectal Neoplasms - pathology; Complement Membrane Attack Complex - analysis; Female; HMGB1 Protein - blood; Humans; Immunologi; Immunology; Inflammation - etiology; Inflammation Mediators - blood; Klinisk medisinske fag: 750; Laparoscopy; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Male; Medical disciplines: 700; Medisinske Fag: 700; Middle Aged; Oncology: 762; Onkologi: 762; VDP
• ISSN: 0025-7974; 1536-5964; 1536-5964
• DOI: 10.1097/MD.0000000000001786

Laparoscopic and open liver resection have not been compared in randomized trials. The aim of the current study was to compare the inflammatory response after laparoscopic and open resection of colorectal liver metastases (CLM) in a randomized controlled trial.This was a predefined exploratory substudy within the Oslo CoMet-study. Forty-five patients with CLM were randomized to laparoscopic (n = 23) or open (n = 22) resection. Ethylenediaminetetraacetic acid-plasma samples were collected preoperatively and at defined time points during and after surgery and snap frozen at -80 C. A total of 25 markers were examined using luminex and enzyme-linked immunosorbent assay techniques: high-mobility box group 1(HMGB-1), cell-free DNA (cfDNA), cytokines, and terminal C5b-9 complement complex complement activation.Eight inflammatory markers increased significantly from baseline: HMGB-1, cfDNA, interleukin (IL)-6, C-reactive protein, macrophage inflammatory protein -1β, monocyte chemotactic protein -1, IL-10, and terminal C5b-9 complement complex. Peak levels were reached at the end of or shortly after surgery. Five markers, HMGB-1, cfDNA, IL-6, C-reactive protein, and macrophage inflammatory protein -1β, showed significantly higher levels in the open surgery group compared with the laparoscopic surgery group.Laparoscopic resection of CLM reduced the inflammatory response compared with open resection. The lower level of HMGB-1 is interesting because of the known association with oncogenesis.