title: Perioperative polyphenon E- and siliphos-inhibited colorectal tumor growth and metastases without impairment of gastric or abdominal wound healing in mouse models.
abstract: BACKGROUND
  Perioperative anticancer therapy that does not impair wound healing is needed to counter the persistent proangiogenic plasma compositional changes that occur after colorectal resection. Polyphenon E (PolyE), a green tea derivative (main component EGCG), and Siliphos (main component silibinin), from the milk thistle plant, both have antitumor effects. This study assessed the impact of PolyE/Siliphos (PES) on wound healing and the growth of CT-26 colon cancer in several murine models.
  
  
  METHODS
  One wound healing and three tumor studies were performed. Tumor Study (TS)1 assessed the impact of PES on subcutaneous tumor growth, whereas TS2 assessed PES's impact on subcutaneous growth when given pre- and post-CO(2) pneumoperitoneum (pneumo), sham laparotomy, or anesthesia alone. TS3 determined the ability of PES to limit hepatic metastases (mets) after portal venous injection of tumor cells. In the final study, laparotomy and gastrotomy wound healing were assessed several ways. BALB/c mice were used for all studies. The drugs were given via drinking water (PolyE) and gavage (Siliphos), daily, for 7-9 days preprocedure and for 7-21 days postoperatively. Tumor mass, number/size of hepatic mets, and proliferation and apoptosis rates were assessed. The abdominal breaking strength and energy to failure were measured postmortem as was gastric bursting pressures.
  
  
  RESULTS
  PES significantly inhibited subcutaneous growth in the nonoperative setting. PES also significantly decreased the number/size of liver mets when given perioperatively. Abdominal wound breaking strength, energy to wound failure, and collagen content were not altered by PES; gastrotomy bursting strength also was not affected by PES. Neither drug alone had a significant impact on tumor growth.
  
  
  CONCLUSIONS
  The PES combination inhibited subcutaneous and hepatic tumor growth yet did not impair wound healing. PES holds promise as a perioperative anticancer therapy.
authors.affiliation: Colon & Rectum Surgery, St. Luke's Roosevelt Hospital Center, 432 West, 58th Street, Room 517, New York, NY 10019, USA. pyan@chpnet.org
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Yan
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Gardner
authors.forename: Michael
authors.initials: M
authors.lastname: Grieco
authors.forename: Sonali A C
authors.initials: SA
authors.lastname: Herath
authors.forename: Joon Ho
authors.initials: JH
authors.lastname: Jang
authors.forename: Daniel
authors.initials: D
authors.lastname: Kirchoff
authors.forename: Linda
authors.initials: L
authors.lastname: Njoh
authors.forename: H M C
authors.initials: HM
authors.lastname: Shantha Kumara
authors.forename: Samer
authors.initials: S
authors.lastname: Naffouje
authors.forename: Richard L
authors.initials: RL
authors.lastname: Whelan
mesh_terms: D000005:Abdomen / Q000502:physiology; D000704:Analysis of Variance; D000818:Animals; D000970:Antineoplastic Agents / Q000494:pharmacology*; D017209:Apoptosis / Q000187:drug effects; D002392:Catechin / Q000031:analogs & derivatives* / Q000494:pharmacology; D045744:Cell Line, Tumor; D049109:Cell Proliferation / Q000187:drug effects; D003094:Collagen; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D004338:Drug Combinations; D005260:Female; D007813:Laparotomy; D051379:Mice; D008807:Mice, Inbred BALB C; D009362:Neoplasm Metastasis; D009368:Neoplasm Transplantation; D059035:Perioperative Period; D011028:Pneumoperitoneum, Artificial; D011312:Pressure; D011897:Random Allocation; D000077385:Silybin; D012838:Silymarin / Q000494:pharmacology*; D013270:Stomach / Q000502:physiology; D013529:Surgical Wound Dehiscence / Q000503:physiopathology; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D000970:Antineoplastic Agents; D004338:Drug Combinations; D012838:Silymarin; D000077385:Silybin; D002392:Catechin; D003094:Collagen; C045651:epigallocatechin gallate; C472086:polyphenon E