Systemic Inflammatory Response After Open, Laparoscopic and Robotic Surgery in Endometrial Cancer Patients

Aim: To study inflammatory response and nutritional biomarkers in operated endometrial cancer (EC) patients. Materials and Methods: A total 109 consecutive EC patients undergoing open laparotomy (LT), laparoscopic (LS) or robot-assisted surgery (RS) were studied. Twenty four patients served as controls. Pre- and postoperative levels of inflammatory and nutritional biomarkers were analyzed prospectively. Results: The estimated blood loss was significantly lower in RS compared to all other groups. C-reactive protein (CRP) and interleukin-6 (IL-6) correlated with each other and exhibited positive correlation with age, body-mass index (BMI), leukocyte count, platelet count, kynurenine, kynurenine/tryptophan ratio and urinary neopterin and a negative correlation with vitamin D and retinol. Hemoglobin, retinol, alpha-tocopherol, vitamin D and citrulline concentrations decreased and inflammatory biomarkers increased after surgery to a different extent in LT, LS, RS and control groups. Conclusion: The present data demonstrate a differential response to surgical trauma in patients with endometrial carcinoma.