title: Minimally invasive colorectal resection is associated with a transient increase in plasma hepatocyte growth factor levels early after surgery for colon cancer.
abstract: BACKGROUND
  Surgery's impact on blood levels of hepatocyte growth factor (HGF), a potent angiogenic factor, is unknown. Preoperative (PreOp) HGF blood levels are elevated in patients with colorectal cancer (CRC) and correlate with disease stage and prognosis. This study's purpose was to determine plasma HGF levels after minimally invasive colorectal resection (MICR) in patients with CRC.
  
  
  METHODS
  Clinical and operative data were collected. Blood samples were obtained in all patients PreOp and on postoperative day (POD) 1 and 3; in some, samples were taken during weeks 2 and 3 after MICR. Late samples were bundled into 7-day time blocks. HGF levels were determined via enzyme-linked immunosorbent assay in duplicate. Student's t test was used to analyze the data (significance, P < .0125 after Bonferroni correction).
  
  
  RESULTS
  A total of 28 CRC patients who underwent MICR were studied. Most had right, sigmoid, or left segmental colectomy. The mean plasma HGF level was higher on POD 1 (2417 ± 1476 pg/mL, P < .001) and POD 3 (2081 ± 1048 pg/mL, P < .001) when compared with PreOp levels (1045 ± 406 pg/mL). Plasma levels were back to baseline by the second (1100 ± 474 pg/mL, P = .64) and third postoperative weeks (1010 ± 327 pg/mL, P = .51).
  
  
  CONCLUSIONS
  MICR for CRC is associated with a 1.9- to 2.3-fold increase in plasma HGF levels during the first 3 PODs after which levels normalize. This transient increase may briefly promote angiogenesis and the growth of residual tumor cells.
authors.affiliation: Department of Colon and Rectal Surgery, St Luke-Roosevelt Hospital Center, New York, NY 10019, USA.
authors.forename: H M C
authors.initials: HM
authors.lastname: Shantha Kumara
authors.forename: Samer T
authors.initials: ST
authors.lastname: Tohme
authors.forename: Ik Y
authors.initials: IY
authors.lastname: Kim
authors.forename: Donald G
authors.initials: DG
authors.lastname: Kim
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Kalady
authors.forename: Martin
authors.initials: M
authors.lastname: Luchtefeld
authors.forename: Keith
authors.initials: K
authors.lastname: Hoffman
authors.forename: Vincent
authors.initials: V
authors.lastname: Dimaggio
authors.forename: Richard L
authors.initials: RL
authors.lastname: Whelan
mesh_terms: D015179:Colorectal Neoplasms / Q000097:blood* / Q000601:surgery*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D017228:Hepatocyte Growth Factor / Q000097:blood*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
chemical_list: D017228:Hepatocyte Growth Factor