BACKGROUND Major postoperative complications have proved to be an independent adverse prognostic factor for long-term survival in patients undergoing cytoreductive surgery(CRS)with or without hyperthermic intraperiton...BACKGROUND Major postoperative complications have proved to be an independent adverse prognostic factor for long-term survival in patients undergoing cytoreductive surgery(CRS)with or without hyperthermic intraperitoneal chemotherapy(HIPEC).C-reactive protein(CRP)is an inflammatory marker that is reportedly a useful tool for the early prediction of postoperative complications,as is the neutrophil-to-lymphocyte ratio(NLR).In patients with peritoneal carcinomatosis,postoperative CRP levels on days 2 to 4 are predictors of early complications after CRS plus HIPEC.AIM To determine the usefulness of CRP and NLR for the early detection of overall postoperative infections(OPIs)after CRS+/-HIPEC.METHODS Patients treated on a peritoneal carcinomatosis program at a tertiary care hospital,in whom complete or optimal cytoreduction was achieved,were analyzed retrospectively.A total of 111 patients were included in this study.CRP and NRL evaluated.RESULTS Of the 111 patients included,19 presented OPI and 8 intra-abdominal infections.Patients with infections had a higher number of digestive anastomoses than those without(1 vs 0.5,P=0.053 and 1.2 vs 0.6,P=0.049)and longer length of stay(19 vs 14.9 days,P=0.022 and 22.3 vs 15.1 days,P=0.006).CRP values above 118 mg/L on POD3 yielded a sensitivity of 66.7%and a specificity of 74.2%to detect OPI.No differences in NLR values were observed.Patients with immunonutrition intake had higher CRP levels regardless of whether they presented OPI.Subsequently,on POD3 and POD4,patients with OPI presented with higher levels of CRP than patients without infection,regardless of the immunonutrition intake.CONCLUSION CRP levels are useful to detect early OPI in patients with peritoneal carcinomatosis undergoing CRS.A cut-off value of 118 mg/L on POD3 yields the best sensitivity and specificity.展开更多
文摘BACKGROUND Major postoperative complications have proved to be an independent adverse prognostic factor for long-term survival in patients undergoing cytoreductive surgery(CRS)with or without hyperthermic intraperitoneal chemotherapy(HIPEC).C-reactive protein(CRP)is an inflammatory marker that is reportedly a useful tool for the early prediction of postoperative complications,as is the neutrophil-to-lymphocyte ratio(NLR).In patients with peritoneal carcinomatosis,postoperative CRP levels on days 2 to 4 are predictors of early complications after CRS plus HIPEC.AIM To determine the usefulness of CRP and NLR for the early detection of overall postoperative infections(OPIs)after CRS+/-HIPEC.METHODS Patients treated on a peritoneal carcinomatosis program at a tertiary care hospital,in whom complete or optimal cytoreduction was achieved,were analyzed retrospectively.A total of 111 patients were included in this study.CRP and NRL evaluated.RESULTS Of the 111 patients included,19 presented OPI and 8 intra-abdominal infections.Patients with infections had a higher number of digestive anastomoses than those without(1 vs 0.5,P=0.053 and 1.2 vs 0.6,P=0.049)and longer length of stay(19 vs 14.9 days,P=0.022 and 22.3 vs 15.1 days,P=0.006).CRP values above 118 mg/L on POD3 yielded a sensitivity of 66.7%and a specificity of 74.2%to detect OPI.No differences in NLR values were observed.Patients with immunonutrition intake had higher CRP levels regardless of whether they presented OPI.Subsequently,on POD3 and POD4,patients with OPI presented with higher levels of CRP than patients without infection,regardless of the immunonutrition intake.CONCLUSION CRP levels are useful to detect early OPI in patients with peritoneal carcinomatosis undergoing CRS.A cut-off value of 118 mg/L on POD3 yields the best sensitivity and specificity.
