November 27, 2017
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Intra-platelet serotonin affects tumor recurrence, morbidity after liver resection

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High perioperative levels of intra-platelet serotonin correlated with early disease recurrence after liver resection, while low levels increased the risk for postoperative morbidity, according to a recently published study.

“During the process of liver regeneration, a microenvironment containing various growth factors is generated. These factors may not only accelerate repair processes but also enhance tumor development and progression by promoting angiogenesis, tumor cell viability and migration,” Robin Padickakudy, from the University of Vienna, and colleagues wrote. “We found ... that a platelet stored growth factor seems to affect both liver regeneration and tumor recurrence, thereby confirming the human relevance of previous experimental studies.”

Padickakudy and colleagues evaluated intra-platelet serotonin (IP5-HT) for its association with oncological outcomes and as a therapeutic target to promote liver regeneration.

The study included 96 patients who underwent liver resection for hepatocellular carcinoma (n = 25), cholangiocellular carcinoma (n = 14) or colorectal cancer liver metastasis (n = 57).

Patients with a disease-free survival of less than 6 months (P = .046) and less than 12 months (P = .02) had significantly higher total IP5-HT levels prior to liver resection. Similarly, tumor recurrence at 1 year or earlier after hepatic resection correlated with significantly increased IP5-HT levels (P < .05).

Among patients with postoperative morbidity (P = .011), severe postoperative morbidity (P = .035) and postoperative liver dysfunction (P = .003), the researchers observed significantly decreased perioperative IP5-HT levels.

Researchers found that preoperative total IP5-HT was a significant predictor of tumor recurrence within 6 months (area under the curve = 69.5%; 95% CI, 0.551-0.839) and 12 months (AUC = 68%; 95% CI, 0.539-0.82).

An IP5-HT cut-off of 73 ng/mL confirmed that patients with excessively low IP5-HT levels had increased incidence rates of postoperative morbidity (P = .015), severe morbidity (P = .019) and liver dysfunction (P = .003). However, the researchers observed a trend in patients with IP5-HT levels below 73 ng/mL for reduced rates of postoperative disease recurrence at both 6 and 12 months.

Patients whose IP5-HT levels exceeded a cut-off of 134 ng/mL had higher incidence rates of tumor recurrence at 6 months (P = 0.049) and 12 months (P = .002) and lower incidence rates of postoperative morbidity (P = .018), severe morbidity (P = .021) and liver dysfunction (P = .044).

“This study brings us one step closer to understanding the role of platelets and platelet-derived 5-HT in the complex processes of liver regeneration and tumor recurrence, highlighting the need for personalized treatment options to guarantee optimal success in oncological treatment of patients undergoing liver resection,” the researchers concluded. – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.