J 2023

Influence of opioid analgesia type on circulating tumor cells in open colorectal cancer surgery (POACC-1): study protocol for a prospective randomized multicenter controlled trial

BERTA, Emil, Josef SROVNAL, Petr DYTRYCH, Jan BRUTHANS, Jitka ULRICHOVA et. al.

Základní údaje

Originální název

Influence of opioid analgesia type on circulating tumor cells in open colorectal cancer surgery (POACC-1): study protocol for a prospective randomized multicenter controlled trial

Autoři

BERTA, Emil (203 Česká republika), Josef SROVNAL (203 Česká republika), Petr DYTRYCH (203 Česká republika), Jan BRUTHANS (203 Česká republika), Jitka ULRICHOVA (203 Česká republika), Petr PRASIL (203 Česká republika), Lubomír VEČEŘA (203 Česká republika, domácí), Tomáš GABRHELÍK (203 Česká republika), Benjamin TOLMACI (203 Česká republika), Josef DUSA (203 Česká republika), Jan MACA (203 Česká republika), Michelle MAZANCOVA (203 Česká republika), Filip HAIDUK (203 Česká republika), Martin KUTEJ (203 Česká republika), Peter IHNAT (203 Česká republika), Pavel MICHALEK (203 Česká republika) a Marian HAJDUCH (203 Česká republika, garant)

Vydání

BMC Anesthesiology, London, BMC, 2023, 1471-2253

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30223 Anaesthesiology

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 2.200 v roce 2022

Kód RIV

RIV/00216224:14110/23:00133351

Organizační jednotka

Lékařská fakulta

UT WoS

000940159000002

Klíčová slova anglicky

Epidural; Morphine; Piritramide; Perioperative analgesia; Colorectal cancer; Cancer recurrence; Circulating tumor cells; Colorectal surgery

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 31. 1. 2024 12:59, Mgr. Tereza Miškechová

Anotace

V originále

BackgroundOpioids and epidural analgesia are a mainstay of perioperative analgesia but their influence on cancer recurrence remains unclear. Based on retrospective data, we found that cancer recurrence following colorectal cancer surgery correlates with the number of circulating tumor cells (CTCs) in the early postoperative period. Also, morphine- but not piritramide-based postoperative analgesia increases the presence of CTCs and shortens cancer-specific survival. The influence of epidural analgesia on CTCs has not been studied yet.MethodsWe intend to enroll 120 patients in four centers in this prospective randomized controlled trial. The study protocol has been approved by Ethics Committees in all participating centers. Patients undergoing radical open colorectal cancer surgery are randomized into epidural, morphine, and piritramide groups for perioperative analgesia. The primary outcome is the difference in the number of CTCs in the peripheral blood before surgery, on the second postoperative day, and 2-4 weeks after surgery. The number of CTCs is measured using molecular biology methods. Perioperative care is standardized, and relevant data is recorded. A secondary outcome, if feasible, would be the expression and activity of various receptor subtypes in cancer tissue. We intend to perform a 5-year follow-up with regard to metastasis development.DiscussionThe mode of perioperative analgesia favorably affecting cancer recurrence would decrease morbidity/mortality. To identify such techniques, trials with long-term follow-up periods seem suboptimal. Given complex oncological therapeutic strategies, such trials likely disable the separation of perioperative analgesia effects from other factors. We believe that early postoperative CTCs presence/dynamics may serve as a sensitive marker of various perioperative interventions ' influences on cancer recurrence. Importantly, it is unbiased to the influence of long-term factors and minimally invasive. Analysis of opioid/cannabinoid receptor subtypes in cancer tissue would improve understanding of underlying mechanisms and promote personalization of treatment. We are not aware of any similar ongoing studies.