<p>Usefulness of Inflammation-Based Prognostic Scores for Predicting the Risk of Complications After Radical Resection of Colorectal Carcinoma</p>

Abstract

These authors contributed equally to this workPurpose: We aimed to investigate the value of inflammation-based prognostic scores for predicting early complications after radical surgery for colorectal carcinoma. Methods: We retrospectively analyzed data of 154 patients who underwent elective resection of colorectal carcinoma between January 2017 and December 2018 at Beijing Friendship Hospital. Univariate, multivariate, and receiver operating characteristic curve analyses were conducted. As inflammation indices, we evaluated the preoperative modified Glasgow Prognostic Score (GPS), as well as the C-reactive protein/albumin ratio (CAR), postoperative GPS, and C-reactive protein levels on postoperative day 3 (POD3). Results: Within 30 days postoperatively, complications occurred in 80 patients (51.9%). And high levels of preoperative mGPS (P=0.002), preoperative CAR (P=0.019), POD3 CAR (P<0.001) and POD3 poGPS (P<0.001) can significantly affect postoperative complications after surgery for colorectal cancer, with CRP on POD3 (odds ratio, 1.015; 95% confidence interval, 1.006-1.024; P=0.001) as independent risk factors. Among all inflammation-based indicators, POD3 CAR had the highest area under the curve (0.711) and positive predictive value (83.2%). Higher CAR (≥2.6) on POD3 was associated with a higher rate of complications (92.9% vs 36.6%, P<0.001), especially of infectious nature (54.8% vs 16.1%, P<0.001). Conclusion: CAR≥2.6 on POD3 reflects sustained systemic inflammation and represents a useful predictor of complications after surgery for colorectal carcinoma, facilitating early detection, timely intervention, and enhanced recovery.

<p>Associations of Postoperative Complications Assessed by Clavien–Dindo Classification and Comprehensive Complication Index with Long-Term Overall Survival in Elderly Patients after Radical CRC Resection</p>

“…Other clinical features, such as CRP:albumin ratio and Geriatric Nutritional Risk Index, have been also identified to be associated with POCs in whole or elderly populations with CRC. 32,33 After exclusion patients with CDC grade V complications, overall POCs (CDC grade II-IV) were identified to be associated with decreased OS in the PSM cohort (n=309), a cohort with similar baseline characteristics, and in the entire cohort (n=601). The sample size of 309 cases in the PSM cohort provided 98.5% power with two-sided α=0.05 and 97% power with two-sided α=0.025 for 3-year OS-rate difference between overall POCs and unremarkable groups, as well as provided 93% power with a two-sided α=0.05 and 88% power with two-sided α=0.025 for 5-year OS-rate difference.…”

Significance of the Glasgow prognostic score for short‐term surgical outcomes: A nationwide survey using the Japanese National Clinical Database

“…The GPS is one of the most useful indexes for predicting long‐term prognosis in various cancers 12–17 . However, the relationship between GPS and postoperative short‐term outcomes remains controversial 18–22 . Preoperative serum levels of CRP and albumin have been reported as the risk factors for postoperative complications and mortality 23–32 .…”

“… 12 , 13 , 14 , 15 , 16 , 17 However, the relationship between GPS and postoperative short‐term outcomes remains controversial. 18 , 19 , 20 , 21 , 22 Preoperative serum levels of CRP and albumin have been reported as the risk factors for postoperative complications and mortality. 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 Despite advances in surgical techniques and devices, some patients who undergo the procedure experience clinically relevant postoperative complications, resulting in a protracted recovery period, delayed administration of adjuvant chemotherapy, and impaired quality of life.…”

“…Several other predictive tools for cancer surgery prognosis have been developed, for example the prognostic nutritional index (PNI), the controlling nutritional status (CONUT) score, the CRP/Albumin ratio, and others. 20 , 21 These tools use a variety of factors that can be measured through standard clinical laboratory tests. However, since the Japanese National Clinical Database (NCD), from which data for this study were obtained, does not store data for factors such as total cholesterol, neutrophil count, and lymphocyte count, we excluded a number of these tools for use in this study.…”

“…Based on previous reports, 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 we hypothesized that the preoperative GPS could predict the postoperative short‐term outcomes as well as long‐term prognosis in various cancers. The present study aimed to investigate the significance of preoperative GPS in predicting postoperative morbidity and mortality in patients with gastrointestinal carcinoma.…”