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Taurolidine reduces the tumor stimulating cytokine interleukin-1beta in patients with resectable gastrointestinal cancer: a multicentre prospective randomized trial.

Braumann C, Gutt CN, Scheele J, Menenakos C, Willems W, Mueller JM, Jacobi CA - World J Surg Oncol (2009)

Bottom Line: The effect of additional treatment strategies with antineoplastic agents on intraperitoneal tumor stimulating interleukin levels are unclear.Perioperative complications did not differ.Reduced cytokine levels might explain a short term antitumorigenic intraperitoneal effect of TRD.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of General, Visceral, Vascular and Thoracic Surgery, Universitaetsmedizin Berlin, Charité Campus Mitte, Humboldt University, Charitéplatz 1, 10117 Berlin, Germany. chris.braumann@charite.de

ABSTRACT

Background: The effect of additional treatment strategies with antineoplastic agents on intraperitoneal tumor stimulating interleukin levels are unclear. Taurolidine and Povidone-iodine have been mainly used for abdominal lavage in Germany and Europe.

Methods: In the settings of a multicentre (three University Hospitals) prospective randomized controlled trial 120 patients were randomly allocated to receive either 0.5% taurolidine/2,500 IU heparin (TRD) or 0.25% povidone-iodine (control) intraperitoneally for resectable colorectal, gastric or pancreatic cancers. Due to the fact that IL-1beta (produced by macrophages) is preoperatively indifferent in various gastrointestinal cancer types our major outcome criterion was the perioperative (overall) level of IL-1beta in peritoneal fluid.

Results: Cytokine values were significantly lower after TRD lavage for IL-1beta, IL-6, and IL-10. Perioperative complications did not differ. The median follow-up was 50.0 months. The overall mortality rate (28 vs. 25, p = 0.36), the cancer-related death rate (17 vs. 19, p = .2), the local recurrence rate (7 vs. 12, p = .16), the distant metastasis rate (13 vs. 18, p = 0.2) as well as the time to relapse were not statistically significant different.

Conclusion: Reduced cytokine levels might explain a short term antitumorigenic intraperitoneal effect of TRD. But, this study analyzed different types of cancer. Therefore, we set up a multicentre randomized trial in patients undergoing curative colorectal cancer resection.

Trial registration: ISRCTN66478538.

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Perioperative IL-1β levels of the peritoneal fluid.
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Figure 3: Perioperative IL-1β levels of the peritoneal fluid.

Mentions: We were interested in the effects of the used intraoperative irrigation fluid on morbidity, mortality rates, as well as on perioperative complications. Therefore, the overall rates are shown in Table 2. In intraperitoneal samples IL-1β values were lower in the TRD group (shown in Figure 3; T3 measurement p = 0.029, T5 p < 0.001, T6 p < 0.001). Similar data were obtained with IL-6 (shown in Table 3a; T3 p = 0.048, T4 p = 0.017, T5 p = 0.003, and T6 p = 0.008), and with IL-10 (in T5, p < 0.001 and T6, p < 0.001). There was no statistically significant difference between other Interleukin values in both groups in the intraperitoneal fluid. No viable tumor cells were detected in T1–T3 situations. T4 sample cytology was positive for malignant cells in only one patient from each group.


Taurolidine reduces the tumor stimulating cytokine interleukin-1beta in patients with resectable gastrointestinal cancer: a multicentre prospective randomized trial.

Braumann C, Gutt CN, Scheele J, Menenakos C, Willems W, Mueller JM, Jacobi CA - World J Surg Oncol (2009)

Perioperative IL-1β levels of the peritoneal fluid.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2667516&req=5

Figure 3: Perioperative IL-1β levels of the peritoneal fluid.
Mentions: We were interested in the effects of the used intraoperative irrigation fluid on morbidity, mortality rates, as well as on perioperative complications. Therefore, the overall rates are shown in Table 2. In intraperitoneal samples IL-1β values were lower in the TRD group (shown in Figure 3; T3 measurement p = 0.029, T5 p < 0.001, T6 p < 0.001). Similar data were obtained with IL-6 (shown in Table 3a; T3 p = 0.048, T4 p = 0.017, T5 p = 0.003, and T6 p = 0.008), and with IL-10 (in T5, p < 0.001 and T6, p < 0.001). There was no statistically significant difference between other Interleukin values in both groups in the intraperitoneal fluid. No viable tumor cells were detected in T1–T3 situations. T4 sample cytology was positive for malignant cells in only one patient from each group.

Bottom Line: The effect of additional treatment strategies with antineoplastic agents on intraperitoneal tumor stimulating interleukin levels are unclear.Perioperative complications did not differ.Reduced cytokine levels might explain a short term antitumorigenic intraperitoneal effect of TRD.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of General, Visceral, Vascular and Thoracic Surgery, Universitaetsmedizin Berlin, Charité Campus Mitte, Humboldt University, Charitéplatz 1, 10117 Berlin, Germany. chris.braumann@charite.de

ABSTRACT

Background: The effect of additional treatment strategies with antineoplastic agents on intraperitoneal tumor stimulating interleukin levels are unclear. Taurolidine and Povidone-iodine have been mainly used for abdominal lavage in Germany and Europe.

Methods: In the settings of a multicentre (three University Hospitals) prospective randomized controlled trial 120 patients were randomly allocated to receive either 0.5% taurolidine/2,500 IU heparin (TRD) or 0.25% povidone-iodine (control) intraperitoneally for resectable colorectal, gastric or pancreatic cancers. Due to the fact that IL-1beta (produced by macrophages) is preoperatively indifferent in various gastrointestinal cancer types our major outcome criterion was the perioperative (overall) level of IL-1beta in peritoneal fluid.

Results: Cytokine values were significantly lower after TRD lavage for IL-1beta, IL-6, and IL-10. Perioperative complications did not differ. The median follow-up was 50.0 months. The overall mortality rate (28 vs. 25, p = 0.36), the cancer-related death rate (17 vs. 19, p = .2), the local recurrence rate (7 vs. 12, p = .16), the distant metastasis rate (13 vs. 18, p = 0.2) as well as the time to relapse were not statistically significant different.

Conclusion: Reduced cytokine levels might explain a short term antitumorigenic intraperitoneal effect of TRD. But, this study analyzed different types of cancer. Therefore, we set up a multicentre randomized trial in patients undergoing curative colorectal cancer resection.

Trial registration: ISRCTN66478538.

Show MeSH
Related in: MedlinePlus