Differences in the prognostic impact of post-operative systemic inflammation and infection in colorectal cancer patients: Using white blood cell counts and procalcitonin levels

Bae, Jung Hoon; Lee, Chul Seung; Han, Sang-Ick; Park, Sun Min; Lee, Yoon Suk; Lee, In Kyu

doi:10.1016/j.suronc.2020.09.017

Cited by 7 publications

(7 citation statements)

References 31 publications

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“…Therefore, PCT can be used as an indicator of severe inflammation, infection, and sepsis. An increasing number of studies have shown that PCT can be used as a sensitive indicator for the early prediction of postoperative infection after surgery [ 6 , 23 – 25 ]. Tatsuoka et al [ 26 ] reported that serum PCT level on POD 4 was effective in the early detection of postoperative infection after laparoscopic colorectal resection.…”

Section: Discussionmentioning

confidence: 99%

Interleukin-6 on postoperative day three as an early predictor of infections following laparoscopic gastric cancer resection

Huang,

Yang,

Yang

et al. 2024

BMC Surg

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Background To investigate the role of C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) as early predictors of infectious complications after laparoscopic gastric cancer surgery. Methods Patients who underwent laparoscopic gastric cancer surgery between January 2020 and June 2022 were retrospectively enrolled. IL-6, PCT, and CRP levels were assessed before surgery and on postoperative days (PODs) 3 and 5. Differences in serum IL-6, PCT, and CRP levels between the infected and non-infected groups were compared. The diagnostic accuracy was determined using the area under the receiver operating characteristic curve (AUC). Results A total of 206 patients were enrolled, and 21 patients (10.19%) developed postoperative infections. Serum IL-6, PCT, and CRP levels in the infected group were significantly higher than those in the non-infected group on PODs 3 and 5. IL-6 with an optimal cutoff value of 84.00 pg/mL (AUC 0.84), PCT with an optimal cutoff value of 1.39 ng/mL (AUC 0.80), CRP with an optimal cutoff value of 150.00 mg/L (AUC 0.76) on POD 3 had superior diagnostic accuracy in predicting postoperative infections. Multivariate analysis identified PCT and IL-6 levels on POD 3 as independent risk factors, the AUC of the combination of IL-6 and PCT was 0.89. The Delong test showed no difference between the AUC of IL-6 alone and IL-6 combined with PCT prediction (P = 0.07, Z = 1.81). Conclusions IL-6 level on POD 3 is an excellent predictor of infectious complications following laparoscopic gastric cancer surgery. Patients with IL-6 levels lower than 84.00 pg/mL on POD 3 can ensure safe early discharge with a low probability of infection.

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Section: Discussionmentioning

confidence: 99%

Interleukin-6 on postoperative day three as an early predictor of infections following laparoscopic gastric cancer resection

Huang,

Yang,

Yang

et al. 2024

BMC Surg

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“…Previously, the prognostic values of CRP, PCT and IL-6 have been individually explored in CRC in preoperative settings; however, only a few studies have been conducted in postoperative settings [ 22 – 27 ]. For example, McSorley et al conducted a study with 377 stage 0-III patients and found that postoperative CRP > 150 mg/L at 4 d was independently associated with poor DFS [ 22 ]; in addition, other studies have also indicated that postoperative CRP could be useful in predicting DFS [ 23 – 25 ] or OS [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…For example, McSorley et al conducted a study with 377 stage 0-III patients and found that postoperative CRP > 150 mg/L at 4 d was independently associated with poor DFS [ 22 ]; in addition, other studies have also indicated that postoperative CRP could be useful in predicting DFS [ 23 – 25 ] or OS [ 26 ]. In addition, Bae et al performed a study with 248 stage I-IV patients and found that postoperative PCT was a risk factor for OS; however, it was not an independent factor [ 27 ]. Notably, no reports to date have explored the role of postoperative IL-6 alone.…”

Section: Discussionmentioning

confidence: 99%

“…It was notable that the prognostic efficacy of CRP and PCT in CRC was inferior to that of IL-6 in the postoperative scenario in our study. In fact, although previous studies have indicated that CRP and PCT were correlated with the outcome either preoperatively [ 4 , 29 – 31 ] or postoperatively [ 23 – 27 ] in CRC, there have also been studies suggesting that these factors would be more useful in predicting infective complications [ 12 , 32 – 34 ] and may not be associated with disease recurrence [ 33 ] or outcome [ 7 , 34 – 37 ]. Moreover, one study indicated that IL-6 was the only independent risk factor for survival in contrast to CRP [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

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Postoperative serum interleukin-6 levels correlate with survival in stage I-III colorectal cancer

Feng

Liu

et al. 2023

BMC Gastroenterol

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Aims The preoperative serum levels of inflammatory mediators, including C-reactive protein (CRP), procalcitonin (PCT) and interleukin-6 (IL-6), have been demonstrated to be correlated with patient outcomes in colorectal cancer (CRC); however, the prognostic role of these levels has been less well-studied in postoperative settings. Materials and methods A total of 122 stage I-III CRC patients were retrospectively enrolled. Serum levels of CRP, PCT and IL-6 were measured after surgery, and their prognostic value was evaluated. Kaplan-Meier analysis was used to determine the differences in disease-free survival (DFS) and overall survival (OS) between patients with different levels of these mediators, and the Cox proportional hazards model was used to estimate the risk factors. Results In contrast to CRP and PCT, only the level of IL-6 was significant in predicting DFS (P = 0.01) but not OS (P = 0.07). A total of 66.39% (81/122) of patients were assigned to the low IL-6 group and no significant differences were found in the collected clinicopathological parameters among the low or high IL-6 subgroups. The level of IL-6 was negatively correlated with postoperative (1 w) (R=-0.24, P = 0.02) absolute lymphocyte counts. Patients with low levels of IL-6 had better DFS (log rank = 6.10, P = 0.01) but not OS (log rank = 2.28, P = 0.13). Finally, the level of IL-6 was an independent risk factor for DFS (HR: 1.81, 95% CI: 1.03–3.15, P = 0.04). Conclusions Compared to CRP and PCT, the level of IL-6 was observed to be the only significant factor in predicting the prognosis of stage I-III CRC patients after surgery, and a low level of IL-6 was associated with good DFS.

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“…Clinical characteristics including tumor site, tumor size, and mitotic rate are the most common indicators for analyzing the risk factors for recurrence after surgery for GIST. Some studies also suggest that the systemic inflammatory response plays an important role in the progression and metastasis of tumors[ 4 ]. The grade of risk classification after operation for GIST is mainly evaluated by the 2008 modified National Institutes of Health (NIH) risk grading standards[ 5 ], the 2020 edition of the World Health Organization soft tissue tumor classification[ 6 ], the National Comprehensive Cancer Network guidelines (6 th edition, 2019)[ 7 ] and the Armed Forces Institute of Pathology criteria[ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Development of an innovative nomogram of risk factors to predict postoperative recurrence of gastrointestinal stromal tumors

Guan¹,

Wang²,

Ma³

et al. 2022

World J Gastrointest Surg

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BACKGROUND There are many staging systems for gastrointestinal stromal tumors (GISTs), and the risk indicators selected are also different; thus, it is not possible to quantify the risk of recurrence among individual patients. AIM To develop and internally validate a model to identify the risk factors for GIST recurrence after surgery. METHODS The least absolute shrinkage and selection operator (LASSO) regression model was performed to identify the optimum clinical features for the GIST recurrence risk model. Multivariable logistic regression analysis was used to develop a prediction model that incorporated the possible factors selected by the LASSO regression model. The index of concordance (C-index), calibration curve, receiver operating characteristic curve (ROC), and decision curve analysis were used to assess the discrimination, calibration, and clinical usefulness of the predictive model. Internal validation of the clinical predictive capability was also evaluated by bootstrapping validation. RESULTS The nomogram included tumor site, lesion size, mitotic rate/50 high power fields, Ki-67 index, intracranial necrosis, and age as predictors. The model presented perfect discrimination with a reliable C-index of 0.836 (95%CI: 0.712-0.960), and a high C-index value of 0.714 was also confirmed by interval validation. The area under the curve value of this prediction nomogram was 0.704, and the ROC result indicated good predictive value. Decision curve analysis showed that the predicting recurrence nomogram was clinically feasible when the recurrence rate exceeded 5% after surgery. CONCLUSION This recurrence nomogram combines tumor site, lesion size, mitotic rate, Ki-67 index, intracranial necrosis, and age and can easily predict patient prognosis.

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Differences in the prognostic impact of post-operative systemic inflammation and infection in colorectal cancer patients: Using white blood cell counts and procalcitonin levels

Cited by 7 publications

References 31 publications

Interleukin-6 on postoperative day three as an early predictor of infections following laparoscopic gastric cancer resection

Interleukin-6 on postoperative day three as an early predictor of infections following laparoscopic gastric cancer resection

Postoperative serum interleukin-6 levels correlate with survival in stage I-III colorectal cancer

Development of an innovative nomogram of risk factors to predict postoperative recurrence of gastrointestinal stromal tumors

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