C-reactive Protein as a Predictor of Postoperative Infective Complications after Curative Resection in Patients with Colorectal Cancer

Platt, Jonathan J.; Ramanathan, Michelle L.; Crosbie, Robin; Anderson, John H.; McKee, Ruth F.; Horgan, Paul G.; McMillan, Donald C.

doi:10.1245/s10434-012-2498-9

Cited by 192 publications

(188 citation statements)

References 37 publications

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“…This is in contrast to CRP, which demonstrated consistent increases on PODs 2-4. In addition, both WBC count and body temperature failed to predict unfavorable outcomes as precisely as increases in CRP did [19,25,26,29,30]. The results of the present study are consistent with previous studies that highlighted the superiority of elevated CRP level over WBC count and body temperature in predicting the development of postoperative infectious complications.…”

Section: Discussionsupporting

confidence: 91%

“…There are several biochemical markers of the acute systemic inflammatory response, including CRP and WBC, and several recent studies have suggested a possible role for CRP in predicting the likelihood of infectious complications after gastrointestinal cancer surgery [19,[25][26][27][28][29][30][31], as shown in Table 3. These studies have proposed that an abnormally elevated CRP level on POD 3 or 4 or persistent elevation of CRP may be a useful predictor of infectious complications.…”

Section: Discussionmentioning

confidence: 99%

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C-reactive protein on postoperative day 3 as a predictor of infectious complications following gastric cancer resection

et al. 2015

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Background Postoperative infectious complications (PICs) after gastric cancer resection remain a clinically relevant problem. Early detection of PICs, before critical illness develops, may be of considerable clinical benefit. The aims of this study were to investigate the predictive factors for PICs and to define the clinical parameters for detecting them early in patients with gastric cancer resection. Methods Clinical data for 417 consecutive patients undergoing elective gastrectomy for primary gastric cancer between 2009 and 2012 were retrospectively analyzed. Conclusions Elevated CRP levels on POD 3 will help physicians predict the postoperative course and facilitate decision-making regarding prompt, comprehensive clinical searches and therapeutic approaches for PICs.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

C-reactive protein on postoperative day 3 as a predictor of infectious complications following gastric cancer resection

et al. 2015

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“…The magnitude of this postoperative systemic inflammatory response, and in particular the routinely available CRP, is associated with the development of complications following colorectal surgery, oesophagectomy and liver resection [8][9][10] Given the relationship between the magnitude of the postoperative systemic inflammatory response, the development of postoperative complications, and long-term outcomes, there is increasing interest in the attenuation of this postoperative stress response.…”

Section: Introductionmentioning

confidence: 99%

The impact of the type and severity of postoperative complications on long-term outcomes following surgery for colorectal cancer: A systematic review and meta-analysis

McSorley

Horgan

McMillan

2016

Critical Reviews in Oncology/Hematology

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Highlights• Systematic review and meta-analysis of preoperative corticosteroids in surgery for GI cancers • Reports significant association between preoperative corticosteroids and lower postoperative IL-6 and CRP • The relationship between corticosteroids and lower postoperative systemic inflammatory response may underpin the impact on postoperative complications This meta-analysis examined the impact of preoperative corticosteroids on interleukin 6 (IL-6), C-reactive protein (CRP), and complications following surgery for gastrointestinal cancer. Keywords Methods:A systematic review was performed using appropriate keywords. Random-effects metaanalysis was performed.Results:11 RCTs with 474 patients, were included. Corticosteroids were significantly associated with lower IL-6 on postoperative day 1 (mean difference -148 pg/mL, 95% CI -205 to -92, p<0.001), 2 (-33 pg/mL, 95% CI -58 to -8, p=0.01), and 3 (-31 pg/mL, 95% CI -52 to -11, p=0.002), lower CRP on day 3 (-45 mg/L, 95% CI -68 to -21, p<0.001), and 7 (-14 mg/L, 95% CI -27 to -1, p=0.04), and fewer postoperative infective complications (OR 0.47, 95%CI 0.26 to 0.83, p=0.01). Conclusion:Corticosteroids were associated with reduction in the postoperative systemic inflammatory response and complications following surgery for gastrointestinal cancer.

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“…Recent evidence suggests that the postoperative systemic inflammatory response, measure by C-reactive protein (CRP), is important in both short and long term outcomes of colorectal patients and that it may be a causal factor in development of postoperative complications [6][7][8][9][10]. A recent comprehensive review has suggested that CRP concentrations exceeding 150mg/L on postoperative days 3 to 5 should alert clinicians to the possible development of postoperative complications, including anastomotic leakage, precluding early discharge [11].…”

Section: Introductionmentioning

confidence: 99%

The relationship between systemic inflammation and stoma formation following anterior resection for rectal cancer: A cross-sectional study

Khor

McSorley

Horgan

et al. 2017

International Journal of Surgery

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Tel: 0141 211 4000Running title: Inflammation and permanent stoma rate Disclosure: no conflicts of interest, no financial support/interests Keywords: colorectal cancer, stoma, stress response, morbidity 2 Abstract IntroductionThere is evidence that temporary defunctioning stoma formation in patients undergoing anterior resection reduces the risk of anastomotic leakage. The aim of the present study was to investigate the relationship between stoma formation, the postoperative systemic inflammatory response and complications following anterior resection for rectal cancer. ResultsOf the 167 patients, the majority were male (61%) and over 65 years old (56%) with node negative disease (60%). 36 patients (22%) underwent preoperative neoadjuvant treatment. 100 patients (60%) had a stoma formed at the time of surgery. Stoma formation was significantly associated with male sex (69% vs. 50%, p=0.017), neoadjuvant chemoradiotherapy (30% vs 9%, p=0.001) and open surgery (71% vs. 55%, p=0.040). Of those 100 patients who had a stoma formed, 80 had it reversed. Permanent stoma was significantly associated with increasing age (p=0.011), exceeding the established CRP threshold of 150mg/L on postoperative day 4 (67% vs 37%, p=0.039), higher incidence of 3 postoperative complications (76% vs 47%, p=0.035), anastomotic leakage (24% vs 2%, p=0.003) and higher Clavien Dindo score (p=0.036). ConclusionsThere was no significant association between stoma formation during anterior resection and the postoperative systemic inflammatory response. However, in these patients both the postoperative systemic inflammatory response and complications were associated with permanent stoma.  Both inflammatory response and complications were associated with permanent stoma.5

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C-reactive Protein as a Predictor of Postoperative Infective Complications after Curative Resection in Patients with Colorectal Cancer

Cited by 192 publications

References 37 publications

C-reactive protein on postoperative day 3 as a predictor of infectious complications following gastric cancer resection

C-reactive protein on postoperative day 3 as a predictor of infectious complications following gastric cancer resection

The impact of the type and severity of postoperative complications on long-term outcomes following surgery for colorectal cancer: A systematic review and meta-analysis

The relationship between systemic inflammation and stoma formation following anterior resection for rectal cancer: A cross-sectional study

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