Surgical procedure as an inducer of tumor angiogenesis

Exp Oncol. 2010 Sep;32(3):186-9.

Abstract

Surgical resection is the main treatment modality for the vast majority of patients with locally confined solid tumors. The healing process following surgery necessitates extensive angiogenesis which can be a clinical challenge due to its tumor-promoting effect. In line with this, plasma (serum) levels of several pro-angiogenic factors such as vascular endothelial growth factor (VEGF) and angiopoietin 2 were found to be significantly increased after surgical tumor resection. Furthermore, increased levels of these proangiogenic factors seem to correlate with the extent of surgical wounding; yet, it remains unknown whether minimal-invasive surgery is superior to open surgery in terms of avoiding the pro-angiogenesis response. Derived from various sources (e.g. endothelial cells, cancer cells, fibroblasts and/or immune cells), an increase of these pro-angiogenic factors can occur as early as day one postoperatively and they can remain persistently elevated for up to four weeks. The presence of such proteins not only supports a microenvironment favorable for tumor growth and metastasis, but also protects tumor cells from conventional chemotherapy. Therefore, initiation of anti-angiogenesis therapies has been proposed for the early postoperative period before the start of conventional chemotherapy. Because such a treatment would potentially affect wound and anastomotic healing, the long-term effects and safety issues associated with early postoperative anti-angiogenic therapy require further investigation.

Publication types

  • Review

MeSH terms

  • Angiogenesis Inducing Agents / blood
  • Angiogenesis Inducing Agents / metabolism*
  • Angiogenesis Inhibitors / therapeutic use
  • Animals
  • Humans
  • Neoplasms / drug therapy
  • Neoplasms / metabolism
  • Neoplasms / surgery*
  • Neovascularization, Pathologic / drug therapy
  • Neovascularization, Pathologic / etiology*
  • Neovascularization, Pathologic / metabolism*

Substances

  • Angiogenesis Inducing Agents
  • Angiogenesis Inhibitors