Minimally invasive colorectal resection is associated with a temporary decrease in FGF-2 levels in both cancer and benign indication patients.

Introduction: Fibroblast growth factor-2 (FGF-2) is a promoter of endothelial cell growth and angiogenesis and, thus, plays a role in both wound healing and tumor growth. Elevated blood levels have been reported in cancer (CRC) patients prior to colorectal resection (CR) and some investigators have noted decreased levels 1 month postop. Surgery’s early impact on plasma FGF-2 levels is unknown. This study’s purpose was to determine FGF-2 levels during the first month after CR.
Methods: A total of 45 cancer and 41 benign indication patients who underwent minimally invasive CR were studied. There were no significant differences in the types of operations performed between groups. Blood samples were obtained preoperatively (preop) and on postoperative day (POD) 1 and 3 in all patients; in a fraction of patients samples were also taken between POD 7-14 or POD 15-30. FGF-2 levels were determined via ELISA; the median result in pg/ml plus the 95% confidence interval was determined for each time point. The POD 7-14 and the POD 15-30 specimens were each bundled and considered as single time points. Wilcoxon’s signed ranks test was used for analysis.
Results: The median preop level in the benign patients (18.9 pg/ml, CI 12.9-23.7) was higher than in the cancer group (13.4 pg/ml, CI 9.7-19.1, p=ns) A significant decrease in FGF-2 levels was noted on both POD 1 and 3 in both the cancer (POD1 6.5 pg/ml, CI 4.6-10.3; POD3 9.1 pg/ml, CI 5.8-15.9) and benign groups (POD1 7.3 pg/ml, CI 4.4-10.4; POD3 8.1 pg/ml, CI 6.3-10.3) when compared to preop results. Although there was no significant difference in levels at the POD 7-14 or 15-30 time points for either group, the cancer group’s values were 3-6 pg/ml lower than preop whereas the benign group’s results were very close to baseline.
Conclusions: No significant difference was noted in the preop FGF-2 levels. Surgery is associated with decreased FGF-2 levels for at least the first 3 days regardless of the indication. FGF-2 levels return to baseline in benign patients while non-significant decreases persist in the cancer patients 2-4 weeks postop. The FGF-2 decrease seen after surgery does not appear to be related to the surgical indication. The clinical significance of this short lived decrease is unclear.

Session: Poster

Program Number: P124

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