Clinicopathological determinants of an elevated systemic inflammatory response following elective potentially curative resection for colorectal cancer

Watt, D. G. , Ramanathan, M. L., McSorley, S. T. , Walley, K., Park, J. H. , Horgan, P. G. and McMillan, D. C. (2017) Clinicopathological determinants of an elevated systemic inflammatory response following elective potentially curative resection for colorectal cancer. Annals of Surgical Oncology, 24(9), pp. 2588-2594. (doi: 10.1245/s10434-017-5987-z) (PMID:28695389) (PMCID:PMC5539269)

Abstract

Introduction: The postoperative systemic inflammatory response (SIR) is related to both long- and short-term outcomes following surgery for colorectal cancer. However, it is not clear which clinicopathological factors are associated with the magnitude of the postoperative SIR. The present study was designed to determine the clinicopathological determinants of the postoperative systemic inflammatory response following colorectal cancer resection. Methods: Patients with a histologically proven diagnosis of colorectal cancer who underwent elective, potentially curative resection during a period from 1999 to 2013 were included in the study (n = 752). Clinicopathological data and the postoperative SIR, as evidenced by postoperative Glasgow Prognostic Score (poGPS), were recorded in a prospectively maintained database. Results: The majority of patients were aged 65 years or older, male, were overweight or obese, and had an open resection. After adjustment for year of operation, a high day 3 poGPS was independently associated with American Society of Anesthesiologists (ASA) grade (hazard ratio [HR] 1.96; confidence interval [CI] 1.25–3.09; p = 0.003), body mass index (BMI) (HR 1.60; CI 1.07–2.38; p = 0.001), mGPS (HR 2.03; CI 1.35–3.03; p = 0.001), and tumour site (HR 2.99; CI 1.56–5.71; p < 0.001). After adjustment for year of operation, a high day 4 poGPS was independently associated with ASA grade (HR 1.65; CI 1.06–2.57; p = 0.028), mGPS (HR 1.81; CI 1.22–2.68; p = 0.003), NLR (HR 0.50; CI 0.26–0.95; p = 0.034), and tumour site (HR 2.90; CI 1.49–5.65; p = 0.002). Conclusions: ASA grade, BMI, mGPS, and tumour site were consistently associated with the magnitude of the postoperative systemic inflammatory response, evidenced by a high poGPS on days 3 and 4, in patients undergoing elective potentially curative resection for colorectal cancer.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Park, Mr James and Ramanathan, Miss Michelle and Horgan, Professor Paul and McMillan, Professor Donald and Watt, David and McSorley, Dr Stephen
• Authors: Watt, D. G., Ramanathan, M. L., McSorley, S. T., Walley, K., Park, J. H., Horgan, P. G., and McMillan, D. C.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Annals of Surgical Oncology
• Publisher: Springer
• ISSN: 1068-9265
• ISSN (Online): 1534-4681
• Published Online: 10 July 2017
• Copyright Holders: Copyright © 2017 The Authors
• First Published: First published in Annals of Surgical Oncology 24(9): 2588-2594
• Publisher Policy: Reproduced under a Creative Commons license