Longitudinal analysis of cytokine expression during neoadjuvant chemoradiotherapy and subsequent surgery in esophageal cancer patients

Abstract Background The purpose of this study was to provide more insight in the course of cytokine concentrations related to pathological response (pR) and complications after neoadjuvant chemoradiotherapy (NCRT) and esophagectomy in esophageal cancer patients. Methods Patients treated with NCRT followed by transthoracic esophagectomy (TTE; N=35) or TTE alone (N=8) were included. Eight different cytokine concentrations were determined during NCRT, esophagectomy and the first postoperative week. Results Platelet activating factor (PAF) before NCRT was associated with pR (p=0.011) and remained elevated in patients with a better response. Concentrations of intestinal fatty acid binding protein and angiopoietin 1 (Ang-1) were different between patients with and without NCRT. Decreased concentrations of Ang-1 on the third postoperative day were associated with postoperative complications (p=0.046). Conclusion In this observational study, elevated PAF concentrations before NCRT were associated with pR. NCRT is associated with decreased Ang-1 concentrations, while reduced Ang-1 concentrations were associated with postoperative complications.