• Annals of surgery · Nov 2015

    Effects of Curative Colorectal Cancer Surgery on Exhaled Volatile Organic Compounds and Potential Implications in Clinical Follow-up.

    • Donato F Altomare, Maria Di Lena, Francesca Porcelli, Elisabetta Travaglio, Francesco Longobardi, Maria Tutino, Norma Depalma, Giuseppina Tedesco, Annamaria Sardaro, Riccardo Memeo, and Gianluigi de Gennaro.
    • *Department of Emergency and Organ Transplantation, Azienda Ospedaliero-Universitaria, Bari, Italy †Department of Chemistry, University Aldo Moro of Bari, Bari, Italy.
    • Ann. Surg. 2015 Nov 1;262(5):862-6; discussion 866-7.

    ObjectiveThe aim of this study was to determine whether the volatile organic compounds (VOCs) pattern in colorectal cancer (CRC) patients is modified by curative surgery for a potential application in the oncologic follow-up.BackgroundCRC has been proved to induce metabolic derangements detectable by high through-output techniques in exhaled breath showing a specific pattern of VOCs.MethodsForty-eight CRC patients and 55 healthy controls (HC) entered the study. Thirty-two patients (M/F: 1.4; mean age 63 years) attended the oncologic follow-up (mean 24 months) and were found disease-free. Breath samples were collected under similar environmental conditions into a Tedlar bags and processed offline by thermal-desorption gas chromatography-mass spectrometry (TD-GC-MS). VOCs were selected by U test to build a Probabilistic Neural Network (PNN) model to set-up a training phase, which was cross-validated using the leave-one out method.ResultsA total of 11 VOCs were finally selected for their excellent discriminant performance in identifying disease-free patients in follow-up from CRC patients before surgery, (sensitivity 100%, specificity 97.92%, accuracy 98.75%, and AUC: 1). The same VOCs pattern discriminated follow-up patients from HC, with a sensitivity of 100%, specificity of 90.91%, accuracy of 94.25%, and AUC 0.959.ConclusionsExhaled VOCs pattern from CRC patients is modified by cancer removal confirming the tight relationship between tumor metabolism and exhaled VOCs. PNN analysis provides a high discriminatory tool to identify patients disease-free after curative surgery suggesting potential implications in CRC screening and secondary prevention.

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