Effect of thoracic epidural anaesthesia on serum vascular endothelial growth factor C and cytokines in patients undergoing anaesthesia and surgery for colon cancer

Br J Anaesth. 2014 Jul:113 Suppl 1:i49-55. doi: 10.1093/bja/aeu148. Epub 2014 Jun 25.

Abstract

Background: Serum vascular endothelial growth factor-C (VEGF-C), transforming growth factor-β (TGF-β), and interleukin (IL)-6 promote angiogenesis and metastases in colon cancer. We hypothesized that patients who received propofol-epidural anaesthesia (PEA) would exhibit decreases in VEGF-C, TGF-β, and IL-6 and an increase in IL-10 compared with patients who received general anaesthesia (GA).

Methods: Colon cancer surgery patients were randomly assigned to the PEA (n=20) or GA (n=20) group. Serum VEGF-C, TGF-β, IL-6, and IL-10 levels before surgery and 24 h after surgery were measured.

Results: Patients who received PEA showed decreases in VEGF-C [526 (261) vs 834 (304) pg ml(-1), P=0.001], TGF-β (P=0.027), and IL-6 (P=0.007) and an increase in IL-10 (P=0.001) 24 h after surgery compared with patients subjected to GA. The visual analogue scale scores at rest and during coughing at 2 and 24 h after operation were significantly lower in PEA patients (P<0.05).

Conclusions: PEA reduces serum concentrations of factors associated with angiogenesis during colon cancer surgery.

Clinical trial registration: ChiCTR-TRC-13003146 (www.chictr.org).

Keywords: anaesthesia, general; anaesthetic techniques, epidural; cancer, colorectal; surgery, colorectal.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesia, Epidural / methods*
  • Anesthesia, General
  • Anesthetics, Intravenous / pharmacology
  • Angiogenesis Inducing Agents / blood
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / surgery*
  • Cytokines / blood*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Proteins / blood
  • Neoplasm Staging
  • Pain Measurement / methods
  • Pain, Postoperative
  • Postoperative Period
  • Propofol / pharmacology
  • Prospective Studies
  • Thoracic Vertebrae
  • Vascular Endothelial Growth Factor C / blood*
  • Young Adult

Substances

  • Anesthetics, Intravenous
  • Angiogenesis Inducing Agents
  • Cytokines
  • Neoplasm Proteins
  • VEGFC protein, human
  • Vascular Endothelial Growth Factor C
  • Propofol