Colorectal Cancer Clinical Trial
Official title:
Microbiome Analysis in esoPhageal, PancreatIc and Colorectal CaNcer Patients Undergoing Gastrointestinal Surgery
The MA-PPING is a multicenter prospective observational study that includes patients
undergoing surgery for gastrointestinal cancer.
The study aims to map the oral and gut microbiome of patients diagnosed with pancreatic,
esophageal or colorectal cancer during their surgical patient journey from the moment of
diagnosis until full recovery (three months after surgery).
Rationale: The gut microbiome is the composition of micro-organisms that reside in the
gastrointestinal tract. Under normal circumstances, the microbiome is balanced and has a
beneficial effect on gut function. However, when the microbiome is stressed i.e. by an
operation, patients' health or medication, the composition of the microbiome may change
rapidly and the virulence of its micro-organisms can increase fast. Surgery, in particular
gastrointestinal surgery, has a disruptive effect on the mucosal gut barrier and may lead to
shifts in microbial composition. Also, the underlying surgical disease itself can be
characterized by changes in the microbiome. Gastrointestinal cancer is associated with
specified alterations of the microbiome, and the presence of certain microbiota is related
with carcinogenesis and lymph node involvement.
Anastomotic leakage is a severe complication after gastrointestinal surgery and several
animal studies linked microbial shifts to the development of anastomotic leakage. Only a few,
small and explorative, human studies investigated the microbiome during surgery and
correlated their findings with the development of postoperative complications. However, the
majority of these studies only sampled the microbiome intraoperatively. Surgery-related
microbial shifts manifest also in the pre- and postoperative phase, therefore, sampling in
these phases is crucial. To further understand the changes of the microbiome composition due
to gastrointestinal surgery and the relation with postoperative infectious complications,
samples should be collected on several time points; before, during, and after surgery. With
this study we aim to map the oral and gut microbiome of patients diagnosed with pancreatic,
esophageal or colorectal cancer in a time frame ranging from the work-up for an operation
until the postoperative phase to assess the changing composition of the microbiome during a
surgical patient journey.
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