The Predictive Value of Clinical and Systemic Inflammatory Biomarkers in Emergency Colic Cancer Surgery: A Retrospective Study.
| Title: | The Predictive Value of Clinical and Systemic Inflammatory Biomarkers in Emergency Colic Cancer Surgery: A Retrospective Study. |
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| Authors: | Silaghi AM; Doctoral School, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Department of General Surgery, St. Pantelimon Emergency Clinical Hospital, 021659 Bucharest, Romania.; Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Serboiu CS; Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Serban D; Doctoral School, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; 4th Department of General Surgery, Emergency University Hospital Bucharest, 050098 Bucharest, Romania.; Constantin VD; Department of General Surgery, St. Pantelimon Emergency Clinical Hospital, 021659 Bucharest, Romania.; Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Tudor C; Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; 4th Department of General Surgery, Emergency University Hospital Bucharest, 050098 Bucharest, Romania.; Motofei I; Department of General Surgery, St. Pantelimon Emergency Clinical Hospital, 021659 Bucharest, Romania.; Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Hussein G; Department of General Surgery, Emergency County Hospital, 130095 Targoviste, Romania.; Stoica PL; 4th Department of General Surgery, Emergency University Hospital Bucharest, 050098 Bucharest, Romania.; Nedea MI; Faculty of Pharmacy, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Dascalu AM; Doctoral School, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Badescu TM; Faculty of Medicine, 'Lucian Blaga' University of Sibiu, 550169 Sibiu, Romania. |
| Source: | Journal of clinical medicine [J Clin Med] 2026 Feb 20; Vol. 15 (4). Date of Electronic Publication: 2026 Feb 20. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101606588 Publication Model: Electronic Cited Medium: Print ISSN: 2077-0383 (Print) Linking ISSN: 20770383 NLM ISO Abbreviation: J Clin Med Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Basel, Switzerland : MDPI AG, [2012]- |
| Abstract: | Background/Objectives: Emergency surgery for complicated colon cancer carries high morbidity and mortality, largely driven by systemic inflammation and organ dysfunction. This study aims to investigate the predictive value of preoperative inflammatory biomarkers for postoperative outcomes. Methods: We retrospectively analyzed 219 patients undergoing emergency surgery for complicated colon cancer. Patients were classified as uncomplicated (n = 164) or complicated (Clavien-Dindo ≥ IIIA; n = 55). Preoperative clinical data, comorbidity indices, laboratory values, and inflammatory markers: C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were assessed. Logistic regression and ROC (Receiver Operating Characteristic) curves analyses identified predictors of Clavien Dindo complications graded as IIIA or higher, anastomotic leak (AL), and in-hospital mortality. Results: Most patients included in the study were males (75.02%), with a mean age of 69.63 (±11.54) years. Patients included in the complicated group had higher comorbidity burden, ASA (American Society of Anesthesiologists) grade, rates of diabetes, organ failure, and systemic inflammatory response. All inflammatory biomarkers were significantly elevated in the complicated group (p < 0.001). CRP (>62.8 mg/dL), NLR (>6.89), and PLR (>334.2) showed good discrimination for Clavien Dindo complications graded as IIIA or higher, with AUC (area under curve) ranging from 0.726 to 0.799. A multivariable model including Charlson Comorbidity Index (CCI), CRP, PLR, and diabetes predicted Clavien-Dindo ≥ IIIA complications with excellent accuracy (AUC 0.870). PLR, creatinine, and diabetes independently predicted AL (AUC 0.834). Mortality (20.5%) was strongly associated with peritonitis, CRP, and NLR (AUC 0.891). Conclusions: Preoperative inflammatory biomarkers, combined with comorbidity and renal function, reliably predict adverse outcomes after emergency colon cancer surgery. Multivariate models may be useful for early risk stratification and support individualized perioperative management. |
| Contributed Indexing: | Keywords: C-reactive protein (CRP); anastomotic leak (AL); colon cancer; complications; emergency surgery; platelet-to-lymphocyte ratio (PLR); systemic inflammation biomarkers; the neutrophil-to-lymphocyte ratio (NLR) |
| Entry Date(s): | Date Created: 20260227 Date Completed: 20260227 Latest Revision: 20260301 |
| Update Code: | 20260301 |
| PubMed Central ID: | PMC12942449 |
| DOI: | 10.3390/jcm15041627 |
| PMID: | 41753314 |
| Database: | MEDLINE |
Journal Article