P-9 Prognostic role of preoperative inflammation parameters in predicting postoperative complications of colorectal cancer surgery

Infectious complications in colorectal cancer surgery is one of the major problems in postoperative complications structure. The frequency of the latter is 5-22%, and in 5-20% of cases such complications lead to death. It should be noted that the development of postoperative complications leads to a decrease in the quality of life of patients, general and relapse-free survival of patients operated on for colorectal cancer. One of the promising ways to diagnose postoperative infectious complications after surgery is to assess the level of biological markers of plasma inflammation. It can be used to identify patients with a high probability of infection and be an indication for earlier additional methods of diagnosing complications. Currently, biomarkers that are used for early postoperative infection detection include increase in the leukocytes level in peripheral blood, CRP, PCT, CD64 neutrophils and others. Despite the large number of studies, the question of the role of these biomarkers in postoperative infections diagnosis in the patients who under went colorectal cancer surgery remains unclear.

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Optimal Assessment of Frailty Predicts Postoperative Complications in Older Patients with Colorectal Cancer Surgery

World Journal of Surgery ◽

10.1007/s00268-020-05886-4 ◽

2021 ◽

Author(s):

Koichi Tamura ◽

Kenji Matsuda ◽

Yoichi Fujita ◽

Makoto Iwahashi ◽

Kazunari Mori ◽

...

Keyword(s):

Colorectal Cancer ◽

Postoperative Complications ◽

Older Patients ◽

Cancer Surgery ◽

Colorectal Cancer Surgery

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Center-Level Procedure Volume Does Not Predict Failure-to-Rescue After Severe Complications of Oncologic Colon and Rectal Surgery

World Journal of Surgery ◽

10.1007/s00268-021-06296-w ◽

2021 ◽

Author(s):

Miriam Lillo-Felipe ◽

Rebecka Ahl Hulme ◽

Maximilian Peter Forssten ◽

Gary A. Bass ◽

Yang Cao ◽

...

Keyword(s):

Colorectal Cancer ◽

Postoperative Complications ◽

High Volume ◽

Cancer Surgery ◽

Colon And Rectal Surgery ◽

Surgical Volume ◽

Failure To Rescue ◽

Colorectal Cancer Surgery ◽

Procedure Volume ◽

Low Volume

Abstract Background The relationship between hospital surgical volume and outcome after colorectal cancer surgery has thoroughly been studied. However, few studies have assessed hospital surgical volume and failure-to-rescue (FTR) after colon and rectal cancer surgery. The aim of the current study is to evaluate FTR following colorectal cancer surgery between clinics based on procedure volume. Methods Patients undergoing colorectal cancer surgery in Sweden from January 2015 to January 2020 were recruited through the Swedish Colorectal Cancer Registry. The primary endpoint was FTR, defined as the proportion of patients with 30-day mortality after severe postoperative complications in colorectal cancer surgery. Severe postoperative complications were defined as Clavien–Dindo ≥ 3. FTR incidence rate ratios (IRR) were calculated comparing center volume stratified in low-volume (≤ 200 cases/year) and high-volume centers (> 200 cases/year), as well as with an alternative stratification comparing low-volume (< 50 cases/year), medium-volume (50–150 cases/year) and high-volume centers (> 150 cases/year). Results A total of 23,351 patients were included in this study, of whom 2964 suffered severe postoperative complication(s). Adjusted IRR showed no significant differences between high- and low-volume centers with an IRR of 0.97 (0.75–1.26, p = 0.844) in high-volume centers in the first stratification and an IRR of 2.06 (0.80–5.31, p = 0.134) for high-volume centers and 2.15 (0.83–5.56, p = 0.116) for medium-volume centers in the second stratification. Conclusion This nationwide retrospectively analyzed cohort study fails to demonstrate a significant association between hospital surgical volume and FTR after colorectal cancer surgery. Future studies should explore alternative characteristics and their correlation with FTR to identify possible interventions for the improvement of quality of care after colorectal cancer surgery.

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Role of the intestinal microbiome in colorectal cancer surgery outcomes

World Journal of Surgical Oncology ◽

10.1186/s12957-019-1754-x ◽

2019 ◽

Vol 17 (1) ◽

Cited By ~ 3

Author(s):

Lelde Lauka ◽

Elisa Reitano ◽

Maria Clotilde Carra ◽

Federica Gaiani ◽

Paschalis Gavriilidis ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Surgery ◽

Intestinal Microbiome ◽

Colorectal Cancer Surgery ◽

Microbiome Composition ◽

Cancer Specific Mortality ◽

Surgery Outcomes ◽

Disease Free

Abstract Objectives Growing evidence supports the role of the intestinal microbiome in the carcinogenesis of colorectal cancers, but its impact on colorectal cancer surgery outcomes is not clearly defined. This systematic review aimed to analyze the association between intestinal microbiome composition and postoperative complication and survival following colorectal cancer surgery. Methods A systematic review was conducted according to the 2009 PRISMA guidelines. Two independent reviewers searched the literature in a systematic manner through online databases, including Medline, Scopus, Embase, Cochrane Oral Health Group Specialized Register, ProQuest Dissertations and Theses Database, and Google Scholar. Human studies investigating the association between the intestinal microbiome and the short-term (anastomotic leakage, surgical site infection, postoperative ileus) and long-term outcomes (cancer-specific mortality, overall and disease-free survival) of colorectal cancer surgery were selected. Patients with any stage of colorectal cancer were included. The Newcastle-Ottawa scale for case-control and cohort studies was used for the quality assessment of the selected articles. Results Overall, 8 studies (7 cohort studies and 1 case-control) published between 2014 and 2018 were included. Only one study focused on short-term surgical outcomes, showing that anastomotic leakage is associated with low microbial diversity and abundance of Lachnospiraceae and Bacteroidaceae families in the non-cancerous resection lines of the stapled anastomoses of colorectal cancer patients. The other 7 studies focused on long-term oncological outcomes, including survival and cancer recurrence. The majority of the studies (5/8) found that a higher level of Fusobacterium nucleatum adherent to the tumor tissue is associated with worse oncological outcomes, in particular, increased cancer-specific mortality, decreased median and overall survival, disease-free and cancer-specific survival rates. Also a high abundance of Bacteroides fragilis was found to be linked to worse outcomes, whereas the relative abundance of the Prevotella-co-abundance group (CAG), the Bacteroides CAG, and the pathogen CAG as well as Faecalibacterium prausnitzii appeared to be associated with better survival. Conclusions Based on the limited available evidence, microbiome composition may be associated with colorectal cancer surgery outcomes. Further studies are needed to elucidate the role of the intestinal microbiome as a prognostic factor in colorectal cancer surgery and its possible clinical implications.

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