Colon Cancer Clinical Trial
Official title:
Effects of Different Types of Perioperative Analgesia on Minimal Residual Disease Development After Colon Cancer Surgery
The aim of this study is to compare the effects of three types of perioperative analgesia on the number of circulating cancer cells (representing minimal residual disease) following radical colon cancer surgery. Patients will be randomized into one of three groups. The intervention group will receive combined regional and general anesthesia during surgery and postoperative epidural analgesia. The two control groups will receive balanced general anesthesia and either morphine-based or piritramide-based postoperative analgesia. We hypothesize that epidural analgesia will be favorable to both piritramide-based and morphine-based analgesia and that piritramide-based analgesia will be favorable to morphine-based analgesia with regard to the number of circulating cancer cells and its development in the early postoperative period.
Techniques of regional analgesia such as epidural analgesia may favorably influence
metastasis development following cancer surgery compared to analgesia based on strong opioids
such as morphine or piritramide. These beneficial effects, if present, are probably
attributable to less immunosuppression of antimetastatic immune defenses.
The aim of this study is to identify techniques of perioperative analgesia with the potential
to prevent metastasis development in patients undergoing open radical colon cancer surgery.
In the early postoperative period, a relationship between metastasis development and the
number of circulating cancer cells representing minimal residual disease has been shown.
Therefore, effects of epidural, morphine-based and piritramide-based analgesia on the number
of circulating cancer cells will be compared at several time points during the peroperative
and early postoperative periods. The number of circulating cancer cells will be assessed in
peripheral venous blood samples using real-time polymerase chain reaction. Perioperative care
will be standardized and patients will be followed by clinical observation, laboratory
analyses and monitoring instrumentation daily during their hospital stay.
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