The Impact of Serum Parameters Associated with Kidney Function on the Short-Term Outcomes and Prognosis of Colorectal Cancer Patients Undergoing Radical Surgery

Abstract

Purpose. The current study was designed to investigate the impact of blood urea nitrogen (BUN), serum uric acid (UA), and cystatin (CysC) on the short-term outcomes and prognosis of colorectal cancer (CRC) patients undergoing radical surgery. Methods. CRC patients who underwent radical resection were included from Jan 2011 to Jan 2020 in a single clinical centre. The short-term outcomes, overall survival (OS), and disease-free survival (DFS) were compared in different groups. A Cox regression analysis was conducted to identify independent risk factors for OS and DFS. Results. A total of 2047 CRC patients who underwent radical resection were included in the current study. Patients in the abnormal BUN group had a longer hospital stay ( p = 0.002 ) and more overall complications ( p = 0.001 ) than that of the normal BUN group. The abnormal CysC group had longer hospital stay ( p < 0.01 ), more overall complications ( p = p < 0.01 ), and more major complications ( p = 0.001 ) than the normal CysC group. Abnormal CysC was associated with worse OS and DFS for CRC patients in tumor stage I ( p < 0.01 ). In Cox regression analysis, age ( p < 0.01 , HR = 1.041, 95% CI = 1.029–1.053), tumor stage ( p < 0.01 , HR = 2.134, 95% CI = 1.828–2.491), and overall complications ( p = 0.002 , HR = 1.499, 95% CI = 1.166–1.928) were independent risk factors for OS. Similarly, age ( p < 0.01 , HR = 1.026, 95% CI = 1.016–1.037), tumor stage ( p < 0.01 , HR = 2.053, 95% CI = 1.788–2.357), and overall complications ( p = 0.002 , HR = 1.440, 95% CI = 1.144–1.814) were independent risk factors for DFS. Conclusion. In conclusion, abnormal CysC was significantly associated with worse OS and DFS at TNM stage I, and abnormal CysC and BUN were related to more postoperative complications. However, preoperative BUN and UA in the serum might not affect OS and DFS for CRC patients who underwent radical resection.

Does chronic kidney disease affect the short-term outcomes and prognosis of colorectal cancer surgery? A propensity score matching analysis

“…Additionally, this endothelial injury could explain the pro-inflammatory environment in CKD due to uremia, malnutrition, volume overload, or altered calcium and phosphorus metabolism ( 32 ). Since inflammatory mediators might lead to malignancy through induction of precancerous mutations, adaptive responses, and environmental changes ( 33 ), this also confirmed the association of CKD with the incidence of CRC ( 7 – 9 ).…”

“…Nowadays, chronic kidney disease (CKD) has become a global public health problem, and Asia has one of the highest prevalence of CKD ( 5 – 7 ). According to statistics, in 2019, there were 9.8 million new CKD cases and 763,024 CKD-related deaths in Asia ( 8 , 9 ).…”