595P - The interim analysis of nutrition and immune recovery and stress response after laparoscopy or open surgery with fast track or conventional treatmen...

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Supportive Care
Colon Cancer
Rectal Cancer
Surgery and/or Radiotherapy of Cancer
Presenter Ke Feng Ding
Authors K.F. Ding, D. Xu, J. Li, Y.M. Song, J.W. Wang, F.F. Sun, J.J. Zhou, J. Zhou, Y. Liu, S.Z. Zhang
  • Department Of Surgical Oncology, 2nd Affiliated Hospital of Zhejiang University, 310009 - Hangzhou/CN

Abstract

Objective

To study the detailed effect of laparoscopy or open surgery with fast track or conventional treatment on patient's postoperative nutrition and immune recovery and stress response.

Methods

Patients with resectable colon cancer and high rectal cancer were randomized to 4 groups: (1) Laparoscopy with fast track treatment (LAFT); (2) Open surgery with fast track treatment (OSFT); (3) Laparoscopy with conventional treatment (LAC); (4) Open surgery with conventional treatment (OSC). Blood samples were collected preoperatively (baseline), and 12, 96 hours after surgery. Peripheral blood levels of albumin, prealbumin, Ig G, Ig A, Ig M and C-reactive protein (CRP) were analyzed.

Results

19 patients were randomized for LAFT group, 18 for OSFT, 17 for LAC, and 19 for OSC. The four groups were balanced with respect to patients' characteristics. Mean albumin level (in percentage from baseline) was 94.35 in the LAFT group, 88.16 in the LAC group, 79.05 in the OSFT group, and 76.50 in the OSC group. Only in LAFT and LAC groups, the albumin level of 96 hours was higher than that of 12 hours, indicating the better potency of postoperative recovery of nutrition status. Similarly, postoperative Ig G levels were also highest in the LAFT group and showed the same rank with albumin levels in the 4 groups. Repeated-measures (2-way ANOVA) indicated the difference of albumin and Ig G can be attributed to surgery type and not perioperative treatment (P < 0.05). CRP levels were highest in the OSC group and lowest in the LAFT group. Further repeated-measures (2-way ANOVA) also indicated it can be attributed to surgery type (P < 0.05). No significant differences were seen between the 4 groups with respect to prealbumin, Ig A or Ig M. No differences in postoperative complication rates such as anastomotic leakage, ileus and wound infection were observed between the groups.

Conclusions

Our FTMDT randomized trial indicats: 1. laparoscopic surgery shortens the period of postoperative nutrition and immune recovery while fast track treatment retards the decrease of postoperative nutrition and immune levels; 2. Combined laparoscopic surgery with fast track treatment provides best postoperative recovery of nutrition and immune status and lowest stress response. This study was registered under NCT01080547 (ClinicalTrials.gov).

Disclosure

All authors have declared no conflicts of interest.