The long term microbiota and metabolic status in patients with colorectal cancer after curative colon surgery

Abstract

Whether there are subsequent changes of metabolic profiles and microbiota status after partial colectomy remains unknown. We evaluated and compared long-term effects of microbiota status and metabolic profiles in early colorectal cancer (CRC) patients after curative colectomy to the controls. In this cross-sectional study, we analyzed metabolic syndrome occurrence in 165 patients after curative partial colectomy with right hemicolectomy (RH) or low anterior resection (LAR) and 333 age-sex matched controls. Fecal samples from some of those with RH, LAR, and controls were analyzed by next-generation sequencing method. The occurrences of metabolic syndrome were significantly higher in patients after RH, but not LAR, when compared with the controls over the long term (> 5 years) follow-up (P = 0.020). Compared with control group, RH group showed lower bacterial diversity (P = 0.007), whereas LAR group showed significantly higher bacterial diversity at the genera level (P = 0.016). Compared with the control group, the principal component analysis revealed significant differences in bacterial genera abundance after RH and LAR (P < 0.001). Furthermore, the Firmicutes to Bacteroidetes ratio was significantly lower in the RH group than the control group (22.0% versus 49.4%, P < 0.05). In conclusion, early CRC patients after RH but not LAR were associated with a higher occurrence of metabolic syndrome than the controls during long-term follow-up. In parallel with metabolic change, patients with RH showed dysbiosis with a tendency to decreased richness and a significant decrease in the diversity of gut microbiota.

The effect of curative resection on fecal microbiota in patients with colorectal cancer: a prospective pilot study

“…Studies have reported that CRC associated dysbiosis did not induce significant changes in the diversity or abundance of microbial communities [17,29]. However, several studies have reported reduced diversity in postoperative patients [24,25,30]. It is known that the use of antibiotics dramatically reduces the diversity of gut microbiota [27].…”

Intestinal Microbiota in Colorectal Cancer Surgery

“…In recent study, Lin et al [ 155 ] were the first to evaluate the long-term metabolic alterations and microbial composition in CRC patients after curative surgery. Metabolic syndrome was more prevalent among CRC patients after right hemicolectomy (RH) but not after lower anterior resection (LAR) compared to controls over a follow-up period of 5 years.…”

Gut Microbiome in Obesity Management

“…Since colon is the main reservoir of gut microbiome, surgical removal of colon may affect gut microbiome [31]. Indeed, right hemicolectomy for colorectal cancer has been reported to be associated with a decrease in diversity and richness of gut microbiome.…”

“…This rich community of microorganisms has co-evolved in a symbiotic relationship with humans. Its diversity is influenced by several factors including host genetics, mode of birth, age, gender, pregnancy, BMI, diet, medications, and surgery [12,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. The understanding of the gut microbiome evolves at a rapid pace, but the practical application of this knowledge is still in its infancy.…”