Propofol but not sevoflurane decreases circulating levels of sEGFR and sE-selectin after colorectal cancer surgery

Abstract

Introduction: Surgery and anaesthesia may affect the outcomes of cancer. The aim of the study was to evaluate the effect of propofol or sevoflurane on cancer biomarkers such as interleukins, adhesion molecules, and EGFR. Material and methods: Eighty patients scheduled for colorectal cancer surgery were randomised to either propofol or sevoflurane anaesthesia. Blood samples for interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor α (TNF-α), interferon α (IFN-α), soluble intracellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), sE-selectin, and sEGFR measurements were obtained before induction of anaesthesia, at the end of surgery, and 72 h postoperatively. Results: Complete samples were obtained from 71 patients. Demographic data and anaesthesia/surgery-related data were similar between the two groups. There were significant differences produced by sevoflurane vs. propofol on the sE-selectin (median (IQR) 57.1 (59.2) vs. 42.7 (22.9) ng/ml, p = 0.011) and sEGFR (median (IQR) 49905.7 (22673.5) vs. 25.657.2 (13842.1) ng/ml, p < 0.001) concentrations postoperatively, while sEGFR plasma levels also showed a significant difference during surgery (median (IQR) 32964.5 (14402.5) vs. 25567.0 (13315.4) ng/ml, p = 0.04). IL-10 levels were significantly higher in the propofol group postoperatively (median (IQR) 13.7 (18.5) vs. 14.9 (66.6) pg/ml, p = 0.05). Conclusions: Given the role of EGFR and adhesion molecules on tumour progression and the generation of metastases, the inhibitory effect of propofol observed in this study might prove useful in the future. Further studies in larger populations investigating the effect of anaesthetic agents on these biomarkers are warranted.