Systemic Inflammatory Response After Open, Laparoscopic and Robotic Surgery in Endometrial Cancer Patients.
OBJECTIVE
To study inflammatory response and nutritional biomarkers in operated endometrial cancer (EC) patients.


METHODS
A total 109 consecutive EC patients undergoing open laparotomy (LT), laparoscopic (LS) or robot-assisted surgery (RS) were studied. Twenty four patients served as controls. Pre- and postoperative levels of inflammatory and nutritional biomarkers were analyzed prospectively.


RESULTS
The estimated blood loss was significantly lower in RS compared to all other groups. C-reactive protein (CRP) and interleukin-6 (IL-6) correlated with each other and exhibited positive correlation with age, body-mass index (BMI), leukocyte count, platelet count, kynurenine, kynurenine/tryptophan ratio and urinary neopterin and a negative correlation with vitamin D and retinol. Hemoglobin, retinol, alpha-tocopherol, vitamin D and citrulline concentrations decreased and inflammatory biomarkers increased after surgery to a different extent in LT, LS, RS and control groups.


CONCLUSIONS
The present data demonstrate a differential response to surgical trauma in patients with endometrial carcinoma.
Department of Obstetrics and Gynecology, Medical Faculty Palacký University and Faculty Hospital, Olomouc, Czech Republic radovan.pilka@fnol.cz.
Radovan
R
Pilka
Department of Obstetrics and Gynecology, Medical Faculty Palacký University and Faculty Hospital, Olomouc, Czech Republic.
Radim
R
Marek
Department of Laboratory Biochemistry, Medical Faculty Palacký University and Faculty Hospital, Olomouc, Czech Republic.
Tomas
T
Adam
Department of Obstetrics and Gynecology, Medical Faculty Palacký University and Faculty Hospital, Olomouc, Czech Republic.
Milan
M
Kudela
Department of Obstetrics and Gynecology, Medical Faculty Palacký University and Faculty Hospital, Olomouc, Czech Republic.
Dana
D
Ondrová
Department of Obstetrics and Gynecology, Medical Faculty Palacký University and Faculty Hospital, Olomouc, Czech Republic.
David
D
Neubert
Department of Obstetrics and Gynecology, Medical Faculty Palacký University and Faculty Hospital, Olomouc, Czech Republic.
Jozef
J
Hambálek
Department of Obstetrics and Gynecology, Medical Faculty Palacký University and Faculty Hospital, Olomouc, Czech Republic.
Martin
M
Maděrka
Third Department of Medicine-Gerontology and Metabolic Care, University Hospital, Hradec Králové, Czech Republic.
Dagmar
D
Solichová
Third Department of Medicine-Gerontology and Metabolic Care, University Hospital, Hradec Králové, Czech Republic.
Lenka Kujovská
LK
Krčmová
Department of Oncology, Medical Faculty Palacký University and Faculty Hospital, Olomouc, Czech Republic.
Bohuslav
B
Melichar
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis; D016889:Endometrial Neoplasms / Q000378:metabolism / Q000601:surgery*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D015850:Interleukin-6 / Q000097:blood; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D019798:Neopterin / Q000652:urine; D011446:Prospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*
D015415:Biomarkers; D015850:Interleukin-6; D019798:Neopterin; D002097:C-Reactive Protein
Endometrial cancer; inflammatory response; nutrition; robotic surgery; surgical trauma