Evaluation of clinical prognostic variables on short-term outcome for colorectal cancer surgery: An overview and minimum dataset. (2022)

• Record Type: Journal Article
• Authors: Cheong, Chee Mei; Golder, Allan M.; Horgan, Paul G.; McMillan, Donald C.; Roxburgh, Campbell S.D.
• Is Part Of: Cancer treatment and research communications. Number 31(2022)
• Publication Date: 2022
• Subjects: Colorectal -- Cancer -- Prognostic factor -- Short-term outcomes
• DOI: 10.1016/j.ctarc.2022.100544
• Languages: English
• ISSNs: 2468-2942

Abstract

Highlights: Multiple validated factors reported to affect short-term outcomes following colorectal cancer. Heterogenous nature of evidence despite multiple systematic reviews on prognostic factors on short term outcome. Diabetes and body composition measurements were consistently reported across short term outcomes. This overview identified factors which have good evidence in terms of post-operative complications to enable careful patient selection using a minimum set of validated risk factors. Recommendation of a minimum and recommended set of baseline variables for future studies to maximise benefit of dataset. Abstract: Introduction: Surgery for colorectal cancer is associated with post-operative morbidity and mortality. Multiple systematic reviews have reported on individual factors affecting short-term outcome following surgical resection. This umbrella review aims to synthesize the available evidence on host and other factors associated with short-term post-operative complications. Methods: A comprehensive search identified systematic reviews reporting on short-term outcomes following colorectal cancer surgery using PubMed, Cochrane Database of Systematic Reviews and Web of Science from inception to 8th September 2020. All reported clinicopathological variables were extracted from published systematic reviews. Results: The present overview identified multiple validated factors affecting short-term outcomes in patients undergoing colorectal cancer resection. In particular, factors consistently associated with post-operative outcome differed with the type of complication; infective, non-infective or mortality. A minimum dataset was identified for future studies and included pre-operative age, sex, diabetes status, body mass index, body composition (sarcopenia, visceral obesity) and functional status (ASA, frailty). A recommended dataset included antibiotic prophylaxis, iron therapy, blood transfusion, erythropoietin, steroid use, enhance recovery programme and finally potential dataset included measures of the systemic inflammatory response Conclusion: A minimum dataset of mandatory, recommended, and potential baseline variables to be included in studies of patients undergoing colorectal cancer resection is proposed. This will maximise the benefit of such study datasets.