Potential Mechanisms of Tumor Progression Associated with Postoperative Infectious Complications

Overview

Journal Cancer Metastasis Rev

Specialty Oncology

Date 2021 Jan 3

PMID 33389285

Citations 12

Authors

Hironori Tsujimoto

Minako Kobayashi

Hidekazu Sugasawa

Satoshi Ono

Yoji Kishi

Hideki Ueno

Affiliations

Soon will be listed here.

Abstract

There is increasing evidence that postoperative infectious complications (PICs) are associated with poor prognosis after potentially curative surgery. However, the role that PICs play in tumor development remains unclear. In this article, we reviewed the literature for novel insights on the mechanisms of cancer progression associated with PICs. The Medline and EMBASE databases were searched for publications regarding the role of suppression of antitumor immunity by PIC in tumor progression and selected 916 manuscripts were selected for this review. In addition, a summary of the authors' own experimental data from this field was set in the context of current knowledge regarding cancer progression under septic conditions. Initially, sepsis/microbial infection dramatically activates the systemic immune system with increases in pro-inflammatory mediators, which results in the development of systemic inflammatory response syndrome; however, when sepsis persists in septic patients, a shift toward an anti-inflammatory immunosuppressive state, characterized by macrophage deactivation, reduced antigen presentation, T cell anergy, and a shift in the T helper cell pattern to a predominantly TH2-type response, occurs. Thus, various cytokine reactions and the immune status dynamically change during microbial infection, including PIC. We proposed three possible mechanisms for the tumor progression associated with PIC: first, a mechanism in which microbes and/or microbial PAMPs may be directly involved in cancer growth; second, a mechanism in which factors released from immunocompetent cells during infections may affect tumor progression; and third, a mechanism in which factors suppress host tumor immunity during infections, which may result in tumor progression. A more detailed understanding by surgeons of the immunological features in cancer patients with PIC can subsequently open new avenues for improving unfavorable long-term oncological outcomes associated with PICs.

Citing Articles

Clinical Significance of Coiled-Coil Domain-Containing Protein 25 Expression in Esophageal Squamous Cell Carcinoma.

Suzuki T, Tsujimoto H, Watanabe T, Ishibashi Y, Fujishima S, Itazaki Y Ann Surg Oncol. 2025; .

PMID: 39953349 DOI: 10.1245/s10434-025-16964-z.

ASO Author Reflections: Coiled-Coil Domain-Containing Protein 25 Expression Related to the Poor Prognosis in Esophageal Squamous Cell Cancer, Especially in the Case with High Neutrophil Counts.

Suzuki T, Tsujimoto H Ann Surg Oncol. 2025; .

PMID: 39937406 DOI: 10.1245/s10434-025-16998-3.

Clinical significance of postoperative complications after pancreatic surgery in time-to-complication and length of postoperative hospital stay: a retrospective study.

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PMID: 38836878 DOI: 10.1007/s00423-024-03369-x.

Pivotal role of myeloid-derived suppressor cells in infection-related tumor growth.

Ito N, Tsujimoto H, Miyazaki H, Takahata R, Ueno H Cancer Med. 2024; 13(4):e6917.

PMID: 38457241 PMC: 10923041. DOI: 10.1002/cam4.6917.

The pathogenesis and potential therapeutic targets in sepsis.

Zhang W, Jiang H, Wu G, Huang P, Wang H, An H MedComm (2020). 2023; 4(6):e418.

PMID: 38020710 PMC: 10661353. DOI: 10.1002/mco2.418.

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