Cancer related nutritional and inflammatory markers as predictive parameters of immediate postoperative complications and long-term survival after hepatectomies. (June 2021)

• Record Type: Journal Article
• Authors: Solanki, Sohan Lal; Kaur, Jasmeen; Gupta, Amit M.; Patkar, Shraddha; Joshi, Riddhi; Ambulkar, Reshma P.; Patil, Akshay; Goel, Mahesh
• Is Part Of: Surgical oncology. Volume 37(2021)
• Publication Date: 2021-06
• Subjects: Albumins -- Disease-free survival -- Hepatectomy -- Inflammation -- Postoperative complications; Cancer -- Surgery -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Electronic journals; 616.994059
• DOI: 10.1016/j.suronc.2021.101526
• Languages: English
• ISSNs: 0960-7404

Abstract

Abstract: Background: The overall survival (OS), disease-free survival (DFS) and complications after liver resections is unsatisfactory. Cancer-related malnutrition and inflammation have an effect on survival but not studied/not clear on postoperative complications. Methods: We retrospectively analyzed prospectively maintained database of 309 patients. The outcome variables included complications in terms of Clavien-Dindo (CD) Score, OS and DFS; We studied effect of preoperative albumin globulin ratio (AGR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and aspartate transaminase to platelet ratio index (APRI) and dynamic change from pre-operative to postoperative value (Delta-AGR, Delta-NLR, Delta-PLR and Delta-APRI) on complications, OS and DFS. Results: Total 98 patients (31.71%) had postoperative complications. Fifty patients had CD 1 & 2 and 35 (11.33%) had CD 3 & 4, and 13 (4.12%) had mortality (CD 5). Low AGR, high NLR, high PLR and high Delta-AGR and high Delta-APRI predicted increased major complications. Preoperative high NLR predicted worse OS and low AGR predicted worse OS and DFS. Delta-APRI showed trends towards worse OS and DFS. Conclusion: These serum inflammatory markers can predict immediate postoperative complications. Preoperative AGR and preoperative NLR can predict survival after liver resections. High Delta-AGR, which is a new entity, is predicting more postoperative complications and needs further detailed studies. Highlights: Low AGR, high NLR, high PLR predicts higher major morbidity after hepatectomies. High Delta-AGR and Delta-APRI predicts higher major morbidity after hepatectomies. Preoperative high NLR predicted worse overall survival (OS) after hepatectomies. Low AGR predicted worse OS and DFS after hepatectomies.