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SSAT 51st Annual Meeting Abstracts

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A Combined Oral Regimen of Egcg and Silibinin Inhibited the Subcutaneous Growth of the Ct-26 Colon Cancer Cell Line and Had No Adverse Effect On Abdominal Or Gastric Wound Healing
Xiaohong Yan*, C. M. Shantha Kumara H, Jennifer Cabot, Raymond Baxter, Keith E. Hoffman, Richard L. Whelan
Colon and Rectal Surgery, St Luke Roosevelt Hospital, New York, NY

Introduction: There is strong evidence that tumor growth is stimulated after colorectal resection in patients with residual tumor microfoci, thus, there is a need for anti-cancer drugs for the perioperative (periop) period. In order for a drug to be used in this time period it is critical that it does not impair wound healing. EGCG (epigallocatechin-3 gallate) from green tea and Silibinin (Silib) from the milk thistle plant, are pro-apoptotic drugs that also impact cell cycle regulation. Alone, each inhibits cancer growth; the efficacy of the 2 together is unknown. This study assessed the tumor inhibitory effect of EGCG and Silib and also studied the impact of these drugs on wound healing.Methods: Tumor Growth Study: CT26 cancer cells were subcutaneously injected into 44 Balb/c J mice that were divided into 4 groups 1) Phosphotidylcholine (Silib delivery vehicle) alone; 2) EGCG alone; 3) Silib alone; and 4) EGCG and Silib. Daily doses of these agents were given orally starting the day after inoculation for 24 days. On day 25 the tumors were excised and weighed; cell proliferation (Ki67) and apoptosis (Caspase3) were assessed via IHC. Wound Healing Study: 4 groups of Balb/c J mice (n=15/group) were given the same drugs in a similar manner. Sham laparotomy and gastrotomy were performed 1 week into treatment. The abdominal wall and gastrotomy wounds were suture closed in 1 layer. On postop day 7 the stomachs and abdominal wall pelts were collected. Stomach bursting pressure and the collagen content of the abdominal wounds were determined. The wounds were also examined histologically.Results: The mean mass of the subcutaneous tumors in the EGCG and Silib group was significantly smaller than that of the control group’s tumors (p=0.02). There was no difference noted in tumor mass when EGCG and Silib where given alone when compared to the control results. IHC analysis showed that only the drug combination inhibited tumor cell proliferation (vs. control, p=0.015) and increased apoptosis (vs control, p=0.030). Periop EGCG and Silib together had no adverse effect on stomach bursting pressure (vs control, p=0.415), wound collagen content (vs control, p=0.379) or the wounds histologic appearance.Conclusions: Whereas, each drug alone was not effective, EGCG and Silib together was found to inhibit tumor growth and proliferation and to encourage apoptosis in this murine model. Importantly, this drug combination did not impair abdominal or gastric wound healing. This drug combination merits further study as a possible perioperative therapy for cancer patients undergoing curative resection.


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