Lymphocyte C-reactive protein ratio: A new biomarker to predict early complications after gastrointestinal oncologic surgery

2021 ◽  
pp. 1-9
Author(s):  
Murat Yildirim ◽  
Bulent Koca
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Inflammatory Markers ◽  
Operation Time ◽  
C Reactive Protein ◽  
Oncologic Surgery ◽  
Protein Ratio ◽  
Colorectal Cancer Surgery ◽  
Neutrophil Lymphocyte Ratio ◽  
Reactive Protein

BACKGROUND: Lymphocyte-to-C-reactive protein ratio (LCR) has been used as a post-surgical prognostic biomarker in patients with gastric and colorectal cancer. However, its relationship with early postoperative complications in these patients is unknown. In this study, we aimed to reveal the relationship between LCR and postoperative complications. METHODS: Eighty-one patients operated for stomach and colorectal cancer between January 2020 and August 2020 were prospectively analyzed. On preoperative and postoperative days 1, 3 and 5, other inflammatory parameters, mainly LCR, neutrophil lymphocyte ratio (NLR), were recorded. The patients were divided into two groups according to Clavien-Dindo classification as stage III and higher complications major, stage I-II/non-complication minor. RESULTS: Fifty seven patients were operated for colorectal cancer, 24 patients for gastric cancer. The mean age of the patients was 65.6 ± 12.6, 34.6% of them was women. Age, operation time and hospital stay were significantly different between the groups (p= 0.004, p= 0.002, p< 0.001). Major complications developed in 18 patients. On postoperative day 5, LCR found superior diagnostic accuracy in predicting major postoperative complications compared to other inflammatory markers. On the postoperative 5th day, the cut-off value of LCR was 0.0034, 88.8% (71.9–94.8) sensitivity, and 85.7% (73.6–95.4) selectivity. CONCLUSION: Among different inflammatory markers, postoperative LCR is a safe and effective predictor of postoperative complications, especially after gastric and colorectal cancer surgery on day 5.

scholarly journals Psoas Muscle Index Defined by Computer Tomography Predicts the Presence of Postoperative Complications in Colorectal Cancer Surgery

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 472
Author(s):  
Zalán Benedek ◽  
Szabolcs Todor-Boér ◽  
Loránd Kocsis ◽  
Orsolya Bauer ◽  
Nicolae Suciu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Psoas Muscle ◽  
Albumin Level ◽  
Cancer Surgery ◽  
High Grade ◽  
C Reactive Protein ◽  
Muscle Area ◽  
Colorectal Cancer Surgery ◽  
Reactive Protein

Background and Objectives: Sarcopenia is a recognized prognostic factor for both complications and survival in cancer patients. This study aims to analyze the relationship between sarcopenia measured by psoas muscle index on computer tomography scans and the presence of postoperative complications in colorectal cancer surgery. Materials and Methods: In a prospective study we recorded data from 51 patients who underwent colorectal cancer surgery in the Mures County Clinical Hospital, Romania. Total psoas muscle area and psoas density were measured at the level of the third lumbal vertebra (L3) for further index calculation. We also evaluated the general characteristics and laboratory analyses to obtain more information about status of the patients. Short-term postoperative complications were scored according to the Clavien-Dindo classification. Results: The majority of the 51 patients were male (61%) and the median age was 65 years. More than half of the cancer was located in the rectum (56.9%), a quarter in the right colon (25.5%), the rest in the sigmoid (11.8%), and the left colon (5.9%). Twenty-one patients (41.2%) developed a complication, five (9.8%) of these were Clavien-Dindo grade 3, 4 or 5 (high grade) and sixteen (31.3%) grade 1 or 2 (low grade). The low- and high-grade groups showed a significantly lower right psoas muscle area, left psoas muscle area, total psoas muscle area, and psoas muscle index (p < 0.001 in all cases). Among laboratory analyses, a significantly lower perioperative hematocrit, hemoglobin, and albumin level were found in patients who developed complications. Furthermore we observed that an elevated serum C-reactive protein level was associated with a higher grade of complication (p < 0.043). Conclusions: The psoas muscle index (PMI) influence on the postoperative outcome is an important factor in our single center prospective study and it appears to be a good overall predictor in colorectal surgery. A lower PMI is directly associated with a low or high grade complication by Clavien-Dindo classification. Perioperative inflammatory and nutritional status evidenced by serum C-reactive protein (CRP) and albumin level influences the presence of postoperative complications.

scholarly journals Predictor of septic complications in colorectal cancer surgery

2018 ◽  
Vol 11 (1) ◽  
pp. 33-37
Author(s):  
Ilgiz Gabdullovitch Gataullin ◽  
Valeriy Germanovitch Savinkov ◽  
Sergey Aleksandrovitch Frolov ◽  
Alexey Mihailovitch Kozlov
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Good Prognosis ◽  
Early Postoperative Period ◽  
C Reactive Protein ◽  
Colorectal Cancer Surgery ◽  
Septic Complications ◽  
Reactive Protein ◽  
Hospital Patients ◽  
Colorectal Cancer Patients

Prediction in colorectal surgery is very useful instrument in managing the health care system in hospitals. Searching for reliable risk factors of postoperative complications allows to identify patients of a high risk of complications group and to discharge earlier from hospital patients with a good prognosis. C-reactive protein is well known as a sensitive and dynamic marker of systemic inflammatory response syndrome. This study evaluated the feasibility of using C-reactive protein as predictor of septic postoperative complications. It was shown that analysis of serum CRP in early postoperative period   allows to predict septic postoperative complications in colorectal cancer patients.

scholarly journals Preoperative C-reactive protein and other inflammatory markers as predictors of postoperative complications in patients with colorectal neoplasia

2021 ◽  
Author(s):  
Sufana Alsaif ◽  
Ailín C Rogers ◽  
Priscilla Pua ◽  
Paul T Casey ◽  
Geoff G Aherne ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Colorectal Surgery ◽  
Inflammatory Markers ◽  
Postoperative Morbidity ◽  
Colorectal Neoplasia ◽  
Full Blood Count ◽  
C Reactive Protein ◽  
Elective Colorectal Surgery ◽  
Reactive Protein ◽  
Grade 3

Abstract Background: Inflammatory markers are measured following colorectal surgery to detect postoperative complications. However, the association of these markers preoperatively with subsequent postoperative course has not yet been usefully studied. Aim: The aim of this study is to assess the ability of preoperative C-reactive protein (CRP) and other inflammatory marker measurements in the prediction of postoperative morbidity after elective colorectal surgery. Methods: This retrospective study catalogues 218 patients undergoing elective, potentially-curative surgery for colorectal neoplasia. Preoperative laboratory results of the full blood count (FBC), C-reactive protein (CRP) and carcinoembryonic antigen (CEA) were recorded. Multivariable analysis was performed to examine preoperative variables against 30-day postoperative complications by type and grade (Clavien-Dindo (CD)), adjusting for age, sex, BMI, smoking status, medical history, open versus laparoscopic operation, and tumor characteristics. Results: Elevated preoperative CRP (≥ 5 mg/L) was significantly predictive of all-cause mortality, with an OR of 17.0 (p < 0.001) and was the strongest factor to predict a CD morbidity grade ≥ 3 (OR 41.9, p < 0.001). Other factors predictive of CD morbidity grade ≥ 3 included smoking, elevated preoperative platelet count and elevated preoperative neutrophil-lymphocyte ratio (OR 15.6, 8.6 and 6.3 respectively, all p < 0.05). CRP values above 5.5 mg/L were indicative of all-cause morbidity (AUC=0.871), and values above 17.5 mg/L predicted severe complications (AUC=0.934). Conclusions: Elevated preoperative CRP predicts increased postoperative morbidity in this patient cohort. The results herein aid risk and resource stratification and encourage preoperative assessment of inflammatory propensity besides simple sepsis exclusion.

The C-reactive protein to albumin ratio predicts postoperative complications in oldest-old patients with colorectal cancer

2020 ◽  
Vol 35 (3) ◽  
pp. 423-431 ◽  
Author(s):  
Shintaro Hashimoto ◽  
Tetsuro Tominaga ◽  
Takashi Nonaka ◽  
Kiyoaki Hamada ◽  
Masato Araki ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Oldest Old ◽  
C Reactive Protein ◽  
Old Patients ◽  
Albumin Ratio ◽  
Reactive Protein
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