The Effect of Complications on Oncological Outcomes of Colorectal Cancer Patients After Primary Surgery: A Propensity Score Matching Analysis

Liu, Xiaoyu; Zhang, Bin; Kang, Bing; Cheng, Yu-Xi; Yuan, Chao; Tao, Wei; Wei, Zheng-Qiang; Peng, Dong

doi:10.3389/fonc.2022.857062

Cited by 8 publications

(4 citation statements)

References 31 publications

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“…In recent years, anastomosis and surgical techniques have developed considerably, but the incidence of post-operative complications in RC has not been significantly reduced ( 9 – 12 ). Several previous studies have shown that post-operative complications affected the prognosis of RC ( 28 – 30 ). Therefore, it was necessary to develop a predictive nomogram for major post-operative complications in RC.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a nomogram to predict the risk factors of major complications after radical rectal cancer surgery

Lv,

Yuan,

et al. 2024

Front. Oncol.

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PurposeThe aim of this study was to establish a validated nomogram to predict risk factors for major post-operative complications in patients with rectal cancer (RC) by analyzing the factors contributing to major post-operative complications in RC patients.MethodsWe retrospectively collected baseline and surgical information on patients who underwent RC surgery between December 2012 and December 2022 at a single-center teaching hospital. The entire cohort was randomly divided into two subsets (60% of the data for development, 40% for validation). Independent risk factors for major post-operative complications were identified using multivariate logistic regression analyses, and predictive models were developed. Area under the curve (AUC) was calculated using receiver operating characteristic curve (ROC) to assess predictive probability, calibration curves were plotted to compare the predicted probability of the nomogram with the actual probability, and the clinical efficacy of the nomogram was assessed using decision curve analysis (DCA).ResultsOur study included 3151 patients who underwent radical surgery for RC, including 1892 in the development set and 1259 in the validation set. Forty (2.1%) patients in the development set and 26 (2.1%) patients in the validation set experienced major post-operative complications. Through multivariate logistic regression analysis, age (p<0.01, OR=1.044, 95% CI=1.016-1.074), pre-operative albumin (p<0.01, OR=0.913, 95% CI=0.866-0.964), and open surgery (p<0.01, OR=2.461, 95% CI=1.284-4.761) were identified as independent risk factors for major post-operative complications in RC, and a nomogram prediction model was established. The AUC of the ROC plot for the development set was 0.7161 (95% Cl=0.6397-0.7924), and the AUC of the ROC plot for the validation set was 0.7191 (95% CI=0.6182-0.8199). The predicted probabilities in the calibration curves were highly consistent with the actual probabilities, which indicated that the prediction model had good predictive ability. The DCA also confirmed the good clinical performance of the nomogram.ConclusionIn this study, a validated nomogram containing three predictors was created to identify risk factors for major complications after radical RC surgery. Due to its accuracy and convenience, it could contribute to personalized management of patients in the perioperative period.

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Section: Discussionmentioning

confidence: 99%

Development and validation of a nomogram to predict the risk factors of major complications after radical rectal cancer surgery

Lv,

Yuan,

et al. 2024

Front. Oncol.

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“…The serum albumin, as an indicator of the nutritional status of the body, was associated with system inflammation [ 32 , 33 ]. The decreased albumin had huge influence on recovery after surgery [ 34 , 35 ], which might lead to severe postoperative complication [ 4 , 36 , 37 ]. LDH was involved in tumor metabolism [ 38 , 39 ], and elevated LDH was associated with immune suppression [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 – 3 ]. Although the surgical procedures and neoadjuvant chemoradiotherapies had become more and more mature, the prognosis of CRC was still not optimistic [ 4 , 5 ]. It was reported that there were many biomarkers affecting prognosis in CRC patients, including lactate dehydrogenase (LDH), albumin [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of serum lactate dehydrogenase-to-albumin ratio (LAR) on the short-term outcomes and long-term prognosis of colorectal cancer after radical surgery

Shu,

Xiang,

Liu

et al. 2023

BMC Cancer

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Background Whether serum lactate dehydrogenase-to-albumin ratio (LAR) influenced the outcomes of colorectal cancer (CRC) patients after radical surgery remained unclear. Therefore, this study sought to examine how LAR influences the short-term and long-term outcomes of CRC patients who have undergone radical surgery. Methods This study retrospectively included CRC patients who underwent radical resection between January 2011 and January 2020. We compared short-term outcomes, as well as overall survival (OS) and disease-free survival (DFS), among various groups. Both univariate and multivariate logistic regression analyses were utilized to pinpoint independent risk factors associated with overall complications and major complications. Moreover, Cox regression analysis were conducted for OS and DFS. Odds ratio (OR) and Hazard ratio (HR) were adjusted. Results This study encompassed a cohort of 3868 patients. 3440 patients were in the low LAR group and 428 patients constituted the high LAR group. In the high LAR group, patients experienced significantly longer operative times (p < 0.01), larger intraoperative blood loss (p < 0.01), and extended postoperative hospital stays (p < 0.01). Additionally, the incidence of both overall complications (p < 0.01) and major complications (p < 0.01) was higher in the high LAR group compared to the low LAR group. Furthermore, LAR was emerged as an independent prognostic factor for overall complications [OR/95% CI: (1.555/1.237 to 1.954), p < 0.01] and major complications [OR/95% CI: (2.178/1.279 to 3.707), p < 0.01]. As for long-term survival, the high LAR group had worse OS in stage II (p < 0.01) and stage III (p < 0.01). In both stage II (p < 0.01) and stage III (p < 0.01), the high LAR group exhibited poorer DFS. Additionally, according to Cox regression analysis, LAR was identified as an independent predictor for both OS [HR/95% CI: (1.930/1.554 to 2.398), p < 0.01] and DFS [HR/95% CI: (1.750/1.427 to 2.146), p < 0.01]. Conclusion LAR emerged as an independent predictor not only for overall complications and major complications but also for both OS and DFS, highlighting its significance and deserving the attention of surgeons.

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“…Okamura et al ( 20 ) reported that elderly patients with CRC were more suitable for laparoscopic surgery. Compared with traditional open surgery, laparoscopic surgery had a smaller incision, less IBL, a shorter postoperative hospital stay and lower postoperative complications and postoperative mortality ( 29 , 30 ). However, in the present study, no significant difference in surgical approach was found between the larger and the smaller IBL groups.…”

Section: Discussionmentioning

confidence: 99%

Effect of intraoperative blood loss on postoperative complications and prognosis of patients with colorectal cancer: A meta‑analysis

Li,

Shu,

Wen

et al. 2023

Biomed Rep

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The purpose of the present study was to evaluate whether the amount of intraoperative blood loss (IBL) affects the complications and prognosis of patients with colorectal cancer (CRC). The PubMed, EMBASE and the Cochrane Library databases were used to search for eligible studies from inception to November 30, 2020. Hazard ratios (HRs) and 95% confidence intervals (Cls) were pooled up. The overall survival (OS) and disease-free survival (DFS) were compared between the larger IBL group and the smaller IBL group. The present study was performed with RevMan 5.3 (The Cochrane Collaboration). A total of seven studies involving 1,540 patients with CRC were included in the present study. The smaller IBL group had a higher rate of OS (HR=1.45, 95% CI=1.17 to 1.8, P=0.0007) and a higher rate of DFS (HR=1.76, 95% CI=1.40 to 2.21, P<0.00001). Furthermore, the larger IBL group had a higher rate of postoperative complications than the smaller IBL group (odds ratio=2.06, 95% CI=1.72 to 2.15, P<0.00001). In conclusion, a smaller IBL was associated with better OS and DFS, and a lower risk of postoperative complications compared with a larger IBL in patients with CRC, suggesting that surgeons should pay more attention during perioperative management and surgical operation to reduce IBL.

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The Effect of Complications on Oncological Outcomes of Colorectal Cancer Patients After Primary Surgery: A Propensity Score Matching Analysis

Cited by 8 publications

References 31 publications

Development and validation of a nomogram to predict the risk factors of major complications after radical rectal cancer surgery

Development and validation of a nomogram to predict the risk factors of major complications after radical rectal cancer surgery

Effect of serum lactate dehydrogenase-to-albumin ratio (LAR) on the short-term outcomes and long-term prognosis of colorectal cancer after radical surgery

Effect of intraoperative blood loss on postoperative complications and prognosis of patients with colorectal cancer: A meta‑analysis

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