title: [Perioperative immunomodulatory therapy does not decrease postoperative recurrence rate of rectal cancer].
abstract: OBJECTIVE
  To study the effect of perioperative immunomodulatory therapy on postoperative recurrence of rectal cancer.
  
  
  METHODS
  This prospective study was conducted among 238 rectal/anal cancer patients undergoing intersphincteric resection at our center between January, 2010 and January, 2011, among whom 150 were eligible to be included and completed the study. The 150 patients were randomized in a double-blinded fashion into 3 equal groups to receive immunomodulatory therapy with 8 mg/kg celecoxib (group A), 0.4 mg/kg Sou-Medrol (group B), or placebo (group C), given daily from 5 days before surgery to 5 days after surgery, and the postoperative cancer recurrence were compared.
  
  
  RESULTS
  At 3 days after the operation, the 3 groups showed significantly different C-reactive protein (CRP) levels, which decreased obviously in all the 3 groups compared with those at 1 day following the operation (P=0.022), especially in group B. The levels of interleukin-6 (IL-6) at 3 days after the operation also differed significantly between the 3 groups but were lower in all the 3 groups than those at 1 day after the operation (P=0.046), and this reduction was the most obvious in group A. COX-2 expression differed significantly between the 3 groups (P=0.017), among which group A showed the most obvious suppression of COX-2 expression. During the follow-up for a mean of 45 months, no significant difference in the recurrence rate was found between the 3 groups (P=0.549).
  
  
  CONCLUSIONS
  With a lower efficacy than Sou-Medrol in decreasing postoperative inflammation, celecoxib produces a better effect in inhibiting COX-2 expression, but it does not lower postoperative recurrence rate of rectal cancer.
authors.affiliation: West China Medical School/MCQ Group of West China Hospital, Sichuan University, Chengdu 610041, China. E-mail: 450981914@qq.com.
authors.forename: Zhi-Ming
authors.initials: ZM
authors.lastname: Gan
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Wang
authors.forename: Dong-Hao
authors.initials: DH
authors.lastname: Lv
authors.forename: Dan
authors.initials: D
authors.lastname: Liu
authors.forename: Li
authors.initials: L
authors.lastname: Li
mesh_terms: D002097:C-Reactive Protein / Q000378:metabolism; D000068579:Celecoxib; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use; D006801:Humans; D056747:Immunomodulation; D007249:Inflammation; D015850:Interleukin-6 / Q000097:blood; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D011184:Postoperative Period; D011446:Prospective Studies; D011720:Pyrazoles / Q000627:therapeutic use*; D012004:Rectal Neoplasms / Q000601:surgery / Q000628:therapy*; D013449:Sulfonamides / Q000627:therapeutic use*
chemical_list: D052246:Cyclooxygenase 2 Inhibitors; C508600:IL6 protein, human; D015850:Interleukin-6; D011720:Pyrazoles; D013449:Sulfonamides; D002097:C-Reactive Protein; D000068579:Celecoxib