Abstract
Background and objective: Anti-adhesion barriers are currently used during ovarian cancer surgery to decrease adhesion-related morbidity. Adept® (4% icodextrin) solution, a liquid anti-adhesion material, has been widely used during gynecologic surgeries, though the risk of this barrier for oncologic surgery is controversial. The aim of this study was to determine the effect of Adept® solution on the proliferation of ovarian cancer cells. Materials and methods: We assessed the dose- and time-dependent effects of icodextrin on the growth and proliferation of OVCAR-3 and A2780 human ovarian tumor cell lines in vitro. Cell growth was determined by cell number counting. Expressions of cell cycle-regulation proteins (cyclin D1 and cyclin B1) were determined using Western blot analysis. Results: Adept® did not significantly increase ovarian cancer cell growth when tested at various concentrations (0, 1, 5, 10, 15, and 20%, equal to 0, 0.04, 0.2, 0.4, 0.6 and 0.8% icodextrin) and different time points (1–3 days) compared to control cells. Moreover, the protein levels of cyclin D1 and B1 were not overexpression-elevated in icodextrin-treated ovarian cancer cells, either with an increasing concentration or with an increasing treated time. These results demonstrated that Adept® does not activate the growth or proliferation of ovarian cancer cells in either a dose- or time-dependent manner. Conclusions: This study supports the use of Adept® solution as a safe anti-adhesion barrier for ovarian cancer surgery, though further in vivo studies are necessary.
Highlights
Complete cytoreductive surgery is the gold-standard treatment for ovarian cancer [1].there is a risk that damage to the peritoneum and serosa after debulking surgery could lead to extensive intra-abdominal adhesions
OVCAR-3 and A2780 ovarian cancer cell lines were treated with Adept® solution at different ratios (v/v; 0, 1, 5, 10, 15, and 20%, equal to 0, 0.04, 0.2, 0.4, 0.6 and 0.8% icodextrin) and treated with 10% Adept® solution (v/v, equal to 0.4% icodextrin) for various periods of time (1, 2, and 3 days)
For the dose-dependent experiment, cells were treated with 0–20% Adept® solution for 3 days, and cell growth was analyzed
Summary
There is a risk that damage to the peritoneum and serosa after debulking surgery could lead to extensive intra-abdominal adhesions. These adhesions can lead to postoperative bowel obstructions and increase morbidity [2]. The effect of a hyaluronic acid–carboxymethyl cellulose barrier (which was widely adopted in gynecologic fibroid surgery) on cancer cell proliferation has been questioned, as hyaluronic acid has been shown to be involved in tumor cell growth [7,8]. Anti-adhesion barriers are currently used during ovarian cancer surgery to decrease adhesion-related morbidity. Materials and methods: We assessed the dose- and time-dependent effects of icodextrin on the growth and proliferation of OVCAR-3 and A2780 human ovarian tumor cell lines in vitro. Expressions of cell cycle-regulation proteins (cyclin D1 and cyclin B1) were determined using Western blot analysis
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