• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Minimally Invasive Colorectal Resection Is Associated with Decreased Levels of the Tumor Growth Inhibitor Plasma Angiopoietin-Like Protein 4 (angptl4) During the First Month After Surgery Which May Promote Angiogenesis and Tumor Growth

HMC Shantha Kumara, PhD, Daniel Kirchoff, MD, Sajith A Herath, BS, JoonHo Jang, MD, Xiaohong Yan, PhD, Vesna Cekic, RN, Richard L Whelan, MD. St Luke Roosevelt Hospital Center, Department of Colon and Rectal Surgery,New York,NY 10019,USA

Introduction: Angiopoietin-like protein 4 (ANGPTL4) is a secreted protein of the angiopoietin-like family. ANGLPT4 mRNA is frequently found in and near the necrotic areas of tumors and is upregulated in both epithelial tumors and in the endothelial cells (EC’s) of tumor vessels. Expression is regulated by hypoxia in both EC’s and tumor cells; ANGLPT4 accumulates in the extracellular matrix (ECM) of hypoxic EC’s. ECM-bound ANGPTL4 reduces EC adhesion, and decreases EC migration and sprouting. ANGPTL4 also inhibits VEGF-induced vascular permeability and angiogenesis, possibly preventing metastasis by inhibiting tumor cell motility and invasiveness. Perioperative plasma ANGPTL4 levels in cancer patients have not been studied. Our aim was to assess plasma levels during the first month after minimally invasive colorectal resection (MICR) for colorectal cancer (CRC).
Methods: Plasma for this study was obtained from an IRB-approved perioperative plasma and data bank; only cancer patients who underwent elective minimally invasive colorectal resection (MICR) were eligible. Blood samples had been obtained preop and at varying postop time points and were stored at -800C. Only patients for whom preop, POD 3, and at least 1 late postop plasma sample (POD7-67) were available were included in this study. The late samples were bundled into 4 time periods (POD7-13, POD14-20, POD21-27, and POD 28-67) and considered as single time points. ANGPT4 levels were determined in duplicate via ELISA and the results are reported as mean ±SD after logarithmic transformation of the data to a normal distribution. The paired t-test was used for statistical analysis with significance set at p<0.01 (after Bonferoni correction).
Results: 80 MICR patients met the inclusion criteria (43 males/37 female, mean age 66.8 ±13.2 years). Twenty nine percent of patients had rectal tumors and 71% colonic lesions. Mean incision length was 7.1±3.2cm, mean operative time was 241.2±95.0 min., and mean length of stay was 5.9±2.3 days. Final cancer stage breakdown was: stage I, n=24; stage II, n=27; stage III, n=27; and stage IV, n=2. Regarding ANGPTL4 levels, the “n” for each comparison varies widely based on postop plasma availability. The mean PreOp ANGPTL4 level was 247.2 ±230.7 ng/ml for the entire group. Significantly lower mean plasma levels (p<0.001) were noted on POD 3 (161.4±140.4ng/ml, n=80), POD7-13 (144.6±134.5 ng/ml, n=46), POD14-20 (139.0±117.8 ng/ml,n=27), POD21-27 (138.9±202.4,n=20), and for the POD 28-67 (160.1±179.0,n=42) time points when compared to the mean preop results.
Conclusion: Plasma ANGPTL4 levels remain significantly lower than baseline for over a month after MICR. The cause(s) for this notable persistent decrease is unclear. Possible reasons are: 1) removal of the cancer, 2) systemic alterations related to wound healing following surgical trauma. Since ANGPTL4 has many angiogenesis inhibiting effects, this persistent decline after MICR likely promotes wound angiogenesis and may encourage neovascularization in residual micrometastases that remain in some patients after removal of the primary tumor. Further studies are warranted.


Session: SS05
Program Number: S028

36

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2011 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons