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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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Overall survival.
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Figure 5: Overall survival.

Mentions: All enrolled patients were followed-up postoperatively according to a standardized postoperative surveillance protocol. Patients receiving adjuvant chemotherapy in the TRD group did not differ from the control group with the exception of patients with gastric cancer (Table 5). The loco-regional recurrence rate and the distant metastasis rate were both minimal lower (but not statistically significant) in the TRD group as compared to the control group-despite the fact that much more patients with gastric cancer in the control group (n = 7) had received chemotherapy vs. 1 patient in TRD group (Figure 4a and 4b). Similar differences were observed in the time to local recurrences, with patients in TRD group showing distant metastatic diseases at a slightly later time point than the control group. Finally the overall mortality rate was similar in both groups. The overall survival rate and the total disease-free time are shown in figure 5.


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)

Overall survival.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: Overall survival.
Mentions: All enrolled patients were followed-up postoperatively according to a standardized postoperative surveillance protocol. Patients receiving adjuvant chemotherapy in the TRD group did not differ from the control group with the exception of patients with gastric cancer (Table 5). The loco-regional recurrence rate and the distant metastasis rate were both minimal lower (but not statistically significant) in the TRD group as compared to the control group-despite the fact that much more patients with gastric cancer in the control group (n = 7) had received chemotherapy vs. 1 patient in TRD group (Figure 4a and 4b). Similar differences were observed in the time to local recurrences, with patients in TRD group showing distant metastatic diseases at a slightly later time point than the control group. Finally the overall mortality rate was similar in both groups. The overall survival rate and the total disease-free time are shown in figure 5.

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