Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Anticancer Res. 2020 Jun;40(6):3535-3542. doi: 10.21873/anticanres.14342.
BACKGROUND/AIM: Inflammation is known to promote the progression of cancer, and there is increasing evidence that inflammation caused by the antitumor response of the host and post-operative infectious complications worsens the prognosis for colorectal cancer. However, the impact of post-operative inflammation caused by surgical stress on long-term survival is unclear.
A total of 274 patients who underwent curative operation for stage II/III colorectal cancer were enrolled and assessed for the serum C-reactive protein (CRP) levels on postoperative day (POD) 1 and 7 and postoperative infectious complications.
The high POD-1 CRP group had a significantly lower relapse-free and overall survival rate than the low POD-1 CRP group. Similarly, the high POD-7 CRP group had a significantly lower relapse-free and overall survival rate than the low POD-7 CRP group. Sub-group analysis limited to patients without postoperative infectious complications indicated that the high POD-7 CRP group tended to have a lower relapse-free survival rate and a significantly lower overall survival rate than the low POD-7 CRP group.
Inflammation caused by postoperative infectious complications and by surgical stress worsens long-term survival outcomes after a curative operation for colorectal cancer.
背景/目的：炎症被认为会促进癌症的进展，越来越多的证据表明，宿主抗肿瘤反应和术后感染性并发症引起的炎症会使结直肠癌的预后恶化。然而，手术应激引起的术后炎症对长期生存的影响尚不清楚。
共纳入 274 例接受 II/III 期结直肠癌根治性手术的患者，并评估术后第 1 天（POD1）和第 7 天（POD7）的血清 C 反应蛋白（CRP）水平和术后感染性并发症。
高 POD1-CRP 组的无复发生存率和总生存率明显低于低 POD1-CRP 组。同样，高 POD7-CRP 组的无复发生存率和总生存率明显低于低 POD7-CRP 组。排除术后感染性并发症的亚组分析表明，高 POD7-CRP 组的无复发生存率低于低 POD7-CRP 组，总生存率明显低于低 POD7-CRP 组。
术后感染性并发症和手术应激引起的炎症会使结直肠癌根治性手术后的长期生存结果恶化。
