TY - JOUR

T1 - Pre-and perioperative inflammatory biomarkers in older patients resected for localized colorectal cancer

T2 - Associations with complications and prognosis

AU - Dolin, Troels Gammeltoft

AU - Christensen, Ib Jarle

AU - Johansen, Astrid Zedlitz

AU - Nielsen, Hans Jørgen

AU - Jakobsen, Henrik Loft

AU - Klein, Mads Falk

AU - Lund, Cecilia Margareta

AU - Bojesen, Stig Egil

AU - Nielsen, Dorte Lisbeth

AU - Jensen, Benny Vittrup

AU - Johansen, Julia Sidenius

N1 - Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2022/1/1

Y1 - 2022/1/1

N2 - The association between pre-and perioperative inflammatory biomarkers, major compli-cations, and survival rates after resection of colorectal cancer (CRC) in older patients is largely unknown. The aim was to investigate age-dependent differences in these associations. Serum CRP, IL-6, and YKL-40 were measured preoperatively and on the first and second day after resection of CRC (stages I–III) in 210 older (≥70 years) and 191 younger patients (<70 years). The results from the complications was presented as an odds ratio (OR, with a 95% confidence interval (CI)) with logistic regression. Results from the mortality rates were presented as a hazard ratio (HR, with a 95% CI) using Cox proportional hazards regression. The preoperative inflammatory biomarkers were higher in the older vs. the younger patients. The risk of complications was increased in older patients with a high preoperative CRP (OR = 1.25, 95% CI 1.03–1.53), IL-6 (OR = 1.57, 95% CI 1.18–2.08), and YKL-40 (OR = 1.66, 95% CI 1.20–2.28), but not in younger patients. Mortality was higher in younger patients with high preoperative YKL-40 (HR = 1.66, 95% CI 1.06–2.60). This was not found in older patients. Elevated preoperative inflammatory biomarkers among older patients were associated with an increased risk of complications, but not mortality. Preoperative inflammatory biomarkers may be useful in assessing the risk of a complicated surgical course in older patients with CRC.

AB - The association between pre-and perioperative inflammatory biomarkers, major compli-cations, and survival rates after resection of colorectal cancer (CRC) in older patients is largely unknown. The aim was to investigate age-dependent differences in these associations. Serum CRP, IL-6, and YKL-40 were measured preoperatively and on the first and second day after resection of CRC (stages I–III) in 210 older (≥70 years) and 191 younger patients (<70 years). The results from the complications was presented as an odds ratio (OR, with a 95% confidence interval (CI)) with logistic regression. Results from the mortality rates were presented as a hazard ratio (HR, with a 95% CI) using Cox proportional hazards regression. The preoperative inflammatory biomarkers were higher in the older vs. the younger patients. The risk of complications was increased in older patients with a high preoperative CRP (OR = 1.25, 95% CI 1.03–1.53), IL-6 (OR = 1.57, 95% CI 1.18–2.08), and YKL-40 (OR = 1.66, 95% CI 1.20–2.28), but not in younger patients. Mortality was higher in younger patients with high preoperative YKL-40 (HR = 1.66, 95% CI 1.06–2.60). This was not found in older patients. Elevated preoperative inflammatory biomarkers among older patients were associated with an increased risk of complications, but not mortality. Preoperative inflammatory biomarkers may be useful in assessing the risk of a complicated surgical course in older patients with CRC.

KW - Ageing

KW - Colorectal cancer

KW - Complications

KW - CRP

KW - IL-6

KW - Inflammation

KW - Inflammatory biomarkers

KW - Surgery

KW - YKL-40

U2 - 10.3390/cancers14010161

DO - 10.3390/cancers14010161

M3 - Journal article

C2 - 35008324

AN - SCOPUS:85121806400

VL - 14

JO - Cancers

JF - Cancers

SN - 2072-6694

IS - 1

M1 - 161

ER -