Systematic review and meta-analysis of effects of preoperative recombinant interleukin-2 on outcome after gastrointestinal cancer surgery
Patients undergoing gastrointestinal cancer surgery are often immunocompromised and susceptible to infectious complications. Recombinant interleukin-2 (rIL2) activates effector immune cells and stimulates expansion of regulatory T-cells. Systematic review and meta-analysis of published studies investigated the effects of preoperative subcutaneous rIL2 on postoperative outcomes of patients undergoing gastrointestinal cancer surgery. The analysis included 13 RCTs with a total of 504 patients. Lymphocyte counts (cells/mm3) at 1 week postoperative were higher in the intervention group compared to the control group (mean difference 865; 95% CI 26-1705). Surgical site infections (OR 0.13; 95% CI 0.03-0.50) and systemic infections (OR 0.25; 95% CI 0.10-0.60) were less likely to occur in the intervention group. Severe side effects of rIL2 were not reported. The authors conclude that preoperative rIL2-based immunomodulation prevents postoperative immunosuppression while the occurrence of severe side effects does not seem to be relevant.