Shintaro Hashimoto1,2, Tetsuro Tominaga3, Takashi Nonaka2, Kiyoaki Hamada4, Masato Araki4, Hiroaki Takeshita5, Hidetoshi Fukuoka6, Hideo Wada7, Kazuo To7, Hideaki Komatsu1, Kenji Tanaka1, Terumitsu Sawai2, Takeshi Nagayasu2. 1. Department of Surgery, Saiseikai Nagasaki Hospital, 2-5-1 Katafuchi, Nagasaki, 850-0003, Japan. 2. Departments of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. 3. Departments of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. tetsuro.tominaga@nagasaki-u.ac.jp. 4. Department of Surgery, Sasebo City General Hospital, 9-3 Hirasemati, Sasebo, 857-8511, Japan. 5. Department of Surgery, National Hospital Organization Nagasaki Medical Center, 2-1001-1 Kubara, Ōmura, 856-8562, Japan. 6. Department of Surgery, Isahaya General Hospital, 24-1 Eisyohigasi, Isahaya, 854-8501, Japan. 7. Department of Surgery, Ureshino Medical Center, 4279-3 Ureshino, Saga, 843-0393, Japan.
Abstract
PURPOSE: The C-reactive protein to albumin ratio (CAR) is a simple and useful score for predicting the outcomes of patients with various cancers. The aim of this study was to evaluate the CAR and short-term outcomes in oldest-old patients with colorectal cancer. METHODS: A total of 126 patients aged 85 years and older with colorectal cancer who underwent resection for primary colon cancer from April 2015 to December 2018 were included. The preoperative cutoff value of the CAR for predicting postoperative complications was 0.19 on receiver operating characteristic curve analysis. Clinical characteristics and inflammation-based scores were compared between patients with a high CAR (CAR ≥ 0.19, n = 44) and a low CAR (CAR < 0.19, n = 82). RESULTS: A high preoperative CAR level (≥ 0.19) was significantly associated with stoma construction (p = 0.004), blood loss (p = 0.003), postoperative complications (p = 0.016), and systemic inflammation marker levels, including a low neutrophil to lymphocyte ratio (p = 0.006), a low platelet to lymphocyte ratio (p = 0.005), a low prognostic nutritional index (p < 0.001), and a high modified Glasgow prognostic score (p < 0.001). On univariate and multivariate analyses, only the CAR was an independent predictor of postoperative complications (HR 2.864, p = 0.029). CONCLUSIONS: A high CAR was significantly associated with postoperative complications for oldest-old patients with colorectal cancer.
PURPOSE: The C-reactive protein to albumin ratio (CAR) is a simple and useful score for predicting the outcomes of patients with various cancers. The aim of this study was to evaluate the CAR and short-term outcomes in oldest-old patients with colorectal cancer. METHODS: A total of 126 patients aged 85 years and older with colorectal cancer who underwent resection for primary colon cancer from April 2015 to December 2018 were included. The preoperative cutoff value of the CAR for predicting postoperative complications was 0.19 on receiver operating characteristic curve analysis. Clinical characteristics and inflammation-based scores were compared between patients with a high CAR (CAR ≥ 0.19, n = 44) and a low CAR (CAR < 0.19, n = 82). RESULTS: A high preoperative CAR level (≥ 0.19) was significantly associated with stoma construction (p = 0.004), blood loss (p = 0.003), postoperative complications (p = 0.016), and systemic inflammation marker levels, including a low neutrophil to lymphocyte ratio (p = 0.006), a low platelet to lymphocyte ratio (p = 0.005), a low prognostic nutritional index (p < 0.001), and a high modified Glasgow prognostic score (p < 0.001). On univariate and multivariate analyses, only the CAR was an independent predictor of postoperative complications (HR 2.864, p = 0.029). CONCLUSIONS: A high CAR was significantly associated with postoperative complications for oldest-old patients with colorectal cancer.
Entities:
Keywords:
C-reactive protein to albumin ratio; Colorectal cancer; Inflammation-based score; Oldest-old patient; Postoperative complication
Authors: N M Verweij; A H W Schiphorst; H A Maas; D D E Zimmerman; F van den Bos; A Pronk; I H M Borel Rinkes; M E Hamaker Journal: Ann Surg Oncol Date: 2016-01-19 Impact factor: 5.344
Authors: N M Verweij; E T D Souwer; A H W Schiphorst; H A Maas; J E A Portielje; A Pronk; F van den Bos; M E Hamaker Journal: Int J Colorectal Dis Date: 2017-09-20 Impact factor: 2.571
Authors: Marije E Hamaker; Tessa Acampo; Jasper A Remijn; Sebastiaan A C van Tuyl; Apollo Pronk; Edwin S van der Zaag; Heleen A Paling; Carolien H Smorenburg; Sophia E de Rooij; Barbara C van Munster Journal: J Am Geriatr Soc Date: 2013-03-21 Impact factor: 5.562