Is Perioperative systemic inflammation the result of insufficient cortisol production in patients with colorectal cancer?

Ramanathan, M.L., Roxburgh, C.S.D. , Guthrie, G.J.K., Orange, C., Talwar, D., Horgan, P.G. and McMillan, D.C. (2013) Is Perioperative systemic inflammation the result of insufficient cortisol production in patients with colorectal cancer? Annals of Surgical Oncology, 20(7), pp. 2172-2179. (doi: 10.1245/s10434-013-2943-4)

Abstract

Background: Patients with colorectal cancer who have a raised systemic inflammatory response before surgery have been shown to have poorer long-term and short-term outcomes. The presence of an ongoing systemic inflammatory response in these patients may be due to impaired cortisol production. The aim of the present study was to examine the relationship between the perioperative systemic inflammatory response and endogenous cortisol production. Methods: A prospective study was performed to incorporate the assessment of adrenocortical function using synthetic adrenocorticotrophic hormone, a short Synacthen test, as part of the preoperative assessment of patients undergoing resection for colorectal cancer. Results: A total of 80 patients underwent short Synacthen testing. There were no significant associations between the baseline, 30 min, or change (both relative and absolute) in cortisol and age (allp > 0.10), sex (all p > 0.10), site (all p > 0.10), TNM stage (all p > 0.10), modified Glasgow prognostic score (all p > 0.10), NLR (all p > 0.10), white cell count (all p > 0.10) or postoperative C-reactive protein concentrations (all p > 0.10). Conclusions: Impaired cortisol production was uncommon in patients with potentially curable colorectal cancer. The presence of a perioperative systemic inflammatory response was not significantly associated with impaired cortisol production.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ramanathan, Miss Michelle and Horgan, Professor Paul and McMillan, Professor Donald and Orange, Miss Clare and Guthrie, Mr Graeme and Roxburgh, Professor Campbell
• Authors: Ramanathan, M.L., Roxburgh, C.S.D., Guthrie, G.J.K., Orange, C., Talwar, D., Horgan, P.G., and McMillan, D.C.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Annals of Surgical Oncology
• Publisher: Springer-Verlag
• ISSN: 1068-9265
• ISSN (Online): 1534-4681