title: Surgical procedure as an inducer of tumor angiogenesis.
abstract: Surgical resection is the main treatment modality for the vast majority of patients with locally confined solid tumors. The healing process following surgery necessitates extensive angiogenesis which can be a clinical challenge due to its tumor-promoting effect. In line with this, plasma (serum) levels of several pro-angiogenic factors such as vascular endothelial growth factor (VEGF) and angiopoietin 2 were found to be significantly increased after surgical tumor resection. Furthermore, increased levels of these proangiogenic factors seem to correlate with the extent of surgical wounding; yet, it remains unknown whether minimal-invasive surgery is superior to open surgery in terms of avoiding the pro-angiogenesis response. Derived from various sources (e.g. endothelial cells, cancer cells, fibroblasts and/or immune cells), an increase of these pro-angiogenic factors can occur as early as day one postoperatively and they can remain persistently elevated for up to four weeks. The presence of such proteins not only supports a microenvironment favorable for tumor growth and metastasis, but also protects tumor cells from conventional chemotherapy. Therefore, initiation of anti-angiogenesis therapies has been proposed for the early postoperative period before the start of conventional chemotherapy. Because such a treatment would potentially affect wound and anastomotic healing, the long-term effects and safety issues associated with early postoperative anti-angiogenic therapy require further investigation.
authors.affiliation: Department of Surgery, Technische Universität München, Ismaningerstrasse 22, Munich 81675, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Kong
authors.forename: C W
authors.initials: CW
authors.lastname: Michalski
authors.forename: H
authors.initials: H
authors.lastname: Friess
authors.forename: J
authors.initials: J
authors.lastname: Kleeff
mesh_terms: D043925:Angiogenesis Inducing Agents / Q000097:blood / Q000378:metabolism*; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000818:Animals; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000601:surgery*; D009389:Neovascularization, Pathologic / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism*
chemical_list: D043925:Angiogenesis Inducing Agents; D020533:Angiogenesis Inhibitors