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Preoperative inflammation is an independent factor of worse prognosis after colorectal cancer surgery

Authors :
M. Bert
Pablo Ortega-Deballon
Olivier Facy
David Orry
P. Rat
H. Devilliers
Service de Chirurgie Digestive, Cancérologique, Générale, Endocrinienne et Urgences (CHU de Dijon)
Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)
Service de médecine interne et maladies systémiques (SOC 2) [CHU de Dijon]
Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques (CIC-EC)
Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Service de chirurgie [Centre Georges-François Leclerc]
Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL)
UNICANCER-UNICANCER
Lipides - Nutrition - Cancer [Dijon - U1231] (LNC)
Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement
Ortega Deballon, Pablo
Source :
Journal of Visceral Surgery, Journal of Visceral Surgery, Elsevier, 2021, pp.S1878-7886(20)30220-4. ⟨10.1016/j.jviscsurg.2020.08.001⟩
Publication Year :
2021
Publisher :
HAL CCSD, 2021.

Abstract

Summary Background We know that inflammation is related to colorectal cancer prognosis and to the onset of postoperative infections. Objective This study aimed to understand the relationship between preoperative inflammation and the prognosis of colorectal cancer and to elucidate whether the impact of inflammation on cancer prognosis was related to an increased risk of surgical infection or was independent of it. Methods Patients who underwent elective colorectal cancer surgery between November 2011 and April 2014 were included in a prospective database (IMACORS). Preoperative c reactive protein was collected for each patient. Patients were followed up according to the French national guidelines. A cut-off of preoperative CRP of 5 mg/L was chosen. Clinical characteristics were compared according to CRP using Chi2 and Mann–Whitney tests. The Overall Survival (OS) and Disease-Free-Survival (DFS) were compared by Kaplan–Meier curves. A Cox proportional hazards regression model was applied to perform a multivariate analysis of OS and DFS's predictors. Results A total of 254 patients were included. The median age was 68 years old. The median follow up was 41.8 months. The overall median preoperative CRP was 5 mg/L. Preoperative CRP was significantly associated with N status; CRP being significantly higher among patients with colonic cancer and with patients who didn’t receive a neoadjuvant treatment. Multivariate analyse revealed that preoperative CRP is an independent prognostic factor of OS and DFS respectively (HR = 2.34 (1.26–4.31), P = 0.006 and HR = 1.83 (1.15–2.90), P = 0.01). Conclusion Preoperative inflammation measured by CRP is independently related with overall and disease-free survival of colorectal cancer.

Details

Language :
English
ISSN :
18787886
Database :
OpenAIRE
Journal :
Journal of Visceral Surgery, Journal of Visceral Surgery, Elsevier, 2021, pp.S1878-7886(20)30220-4. ⟨10.1016/j.jviscsurg.2020.08.001⟩
Accession number :
edsair.doi.dedup.....f3b55ef2af1c1e72ab5ad1c597c9b921
Full Text :
https://doi.org/10.1016/j.jviscsurg.2020.08.001⟩