Long-term risk of gastrointestinal tumor recurrence after postoperative treatment with recombinant human growth hormone

Background: Recombinant human growth hormone (rhGH) promotes protein synthe sis, accelerates wound healing, and maintains immune function in the catabo lic state. It has also been claimed that rhGH may promote the activation of residual tumor cells, and therefore, increases the risk of tumor recurrenc e. This study aimed to investigate whether postoperative administration of rhGH increases the long-term risk of tumor recurrences in patients undergoi ng major gastrointestinal surgery for malignancy. Methods. Patients (n = 10 4) received three different doses of rhGH (0.075 IU/kg, 0.150 IU/kg, and 0. 300 IU/kg) during 5 postoperative days in a placebo-controlled trial. Follo w-up was per formed for 56-70 months after radical tumor resection. Mean su rvival period and relapse-free survival were compared with the control grou p. Results: Complete data were available for 75 patients. Thirty-five perce nt (n = 20) of all patients treated with rhGH showed tumor recurrences in c omparison to 44% (n = 8) of patients given placebo. Mean survival period fo r rhGH-treated patients was 46 months (median 59 months): in controls, 42 m onths (median 58 months). The length of relapse-free survival tended to be longer in rhGH-treated patients (2-47 months; median, 21 months) compared w ith the patients who were given placebo (2-18 months; median, 13 months). C onclusions: The results demonstrate no evidence for an increased risk of tu mor recurrence after rhGH treatment for a short period of time after remova l of a gastrointestinal adenocarcinoma. Therefore, the positive metabolic e ffects of rhGH application can be used safely in the treatment of the posto perative catabolic state in the patient groups investigated.