NICER: Perioperative neutrophils, infection & cancer recurrence v1
Research type
Research Study
Full title
NICER - Neutrophil alterations In Cancer surgery: Effects on Recurrence and infection
IRAS ID
363271
Contact name
Hew Torrance
Contact email
Sponsor organisation
Imperial College
Duration of Study in the UK
3 years, 0 months, 4 days
Research summary
In the western world one in 10 people will undergo surgery each year. Major abdominal cancer surgery offers a chance of a cure; however, it is frequently complicated by infection and more rarely by cancer recurrence. Up to 40% of patients aged 45 or over undergoing major cancer surgery experience an infective complication. Consequently, they have not only an increased chance of dying, but also a greater risk of failing to regain the quality of life they had before surgery. Worryingly, cancer recurrence rates following apparently curative resections can be as high as 15%, Infection seems to play a role in this process, but we’re unsure how. \n\nWe have previously analysed chemical messenger levels in the blood produced by our genes called RNA. This suggests that surgery itself causes changes to a type of white blood cell, the neutrophil. This cell type is fundamental for not only fighting infection, but also for combatting cancer. There neutrophil changes can increase susceptibility to postoperative infection while simultaneously creating receptive conditions for metastasis and thus later cancer recurrence to occur. These postoperative immune changes resemble those observed in sepsis and those seen in patients with cancer-related immunosuppression. We hope that by investigating this cell-type further, we can begin to understand the specific changes that surgery causes and why some people develop infections or have cancer recurrence, but others remain unaffected.\n\nThis highlights the perioperative period as a critical time window where there is a convergence of infectious and oncological risks. Understanding these mechanisms is essential to identify high-risk patients and to guide new strategies aimed at improving both surgical recovery and long-term cancer outcomes.
REC name
Yorkshire & The Humber - Leeds West Research Ethics Committee
REC reference
26/YH/0035
Date of REC Opinion
5 Mar 2026
REC opinion
Further Information Favourable Opinion