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The modified Glasgow Prognostic Score indicates an increased risk of anastomotic leakage after anterior resection for rectal cancer

BACKGROUND: Preoperative inflammation might cause and also be a marker for anastomotic leakage after anterior resection for rectal cancer. Available biomarker indices such as the modified Glasgow Prognostic Score (mGPS) or the C-reactive protein-to-albumin ratio (CAR) may be clinically useful for le...

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Autores principales: Golshani, Parisa, Park, Jennifer, Häggström, Jenny, Segelman, Josefin, Matthiessen, Peter, Lydrup, Marie-Louise, Rutegård, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10359376/
https://www.ncbi.nlm.nih.gov/pubmed/37470911
http://dx.doi.org/10.1007/s00384-023-04496-5
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author Golshani, Parisa
Park, Jennifer
Häggström, Jenny
Segelman, Josefin
Matthiessen, Peter
Lydrup, Marie-Louise
Rutegård, Martin
author_facet Golshani, Parisa
Park, Jennifer
Häggström, Jenny
Segelman, Josefin
Matthiessen, Peter
Lydrup, Marie-Louise
Rutegård, Martin
author_sort Golshani, Parisa
collection PubMed
description BACKGROUND: Preoperative inflammation might cause and also be a marker for anastomotic leakage after anterior resection for rectal cancer. Available biomarker indices such as the modified Glasgow Prognostic Score (mGPS) or the C-reactive protein-to-albumin ratio (CAR) may be clinically useful for leakage assessment. METHODS: Patients who underwent anterior resection for rectal cancer during 2014–2018 from a multicentre retrospective cohort were included. Data from the Swedish Colorectal Cancer registry and chart review at each hospital were collected. In a subset of patients, preoperative laboratory assessments were available, constituting the exposures mGPS and CAR. Anastomotic leakage within 12 months was the outcome. Causally oriented analyses were conducted with adjustment for confounding, as well as predictive models. RESULTS: A total of 418 patients were eligible for analysis. Most patients had mGPS = 0 (84.7%), while mGPS = 1 (10.8%) and mGPS = 2 (4.5%) were less common. mGPS = 2 (OR: 4.11; 95% CI: 1.69–10.03) seemed to confer anastomotic leakage, while this was not seen for mGPS = 1 (OR 1.09; 95% CI: 0.53–2.25). A cut off point of CAR > 0.36 might be indicative of leakage (OR 2.25; 95% CI: 1.21–4.19). Predictive modelling using mGPS rendered an area-under-the-curve of 0.73 (95% CI: 0.67–0.79) at most. DISCUSSION: Preoperative inflammation seems to be involved in the development of anastomotic leakage after anterior resection for cancer. Inclusion into prediction models did not result in accurate leakage prediction, but high degrees of systemic inflammation might still be important in clinical decision-making. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00384-023-04496-5.
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spelling pubmed-103593762023-07-22 The modified Glasgow Prognostic Score indicates an increased risk of anastomotic leakage after anterior resection for rectal cancer Golshani, Parisa Park, Jennifer Häggström, Jenny Segelman, Josefin Matthiessen, Peter Lydrup, Marie-Louise Rutegård, Martin Int J Colorectal Dis Research BACKGROUND: Preoperative inflammation might cause and also be a marker for anastomotic leakage after anterior resection for rectal cancer. Available biomarker indices such as the modified Glasgow Prognostic Score (mGPS) or the C-reactive protein-to-albumin ratio (CAR) may be clinically useful for leakage assessment. METHODS: Patients who underwent anterior resection for rectal cancer during 2014–2018 from a multicentre retrospective cohort were included. Data from the Swedish Colorectal Cancer registry and chart review at each hospital were collected. In a subset of patients, preoperative laboratory assessments were available, constituting the exposures mGPS and CAR. Anastomotic leakage within 12 months was the outcome. Causally oriented analyses were conducted with adjustment for confounding, as well as predictive models. RESULTS: A total of 418 patients were eligible for analysis. Most patients had mGPS = 0 (84.7%), while mGPS = 1 (10.8%) and mGPS = 2 (4.5%) were less common. mGPS = 2 (OR: 4.11; 95% CI: 1.69–10.03) seemed to confer anastomotic leakage, while this was not seen for mGPS = 1 (OR 1.09; 95% CI: 0.53–2.25). A cut off point of CAR > 0.36 might be indicative of leakage (OR 2.25; 95% CI: 1.21–4.19). Predictive modelling using mGPS rendered an area-under-the-curve of 0.73 (95% CI: 0.67–0.79) at most. DISCUSSION: Preoperative inflammation seems to be involved in the development of anastomotic leakage after anterior resection for cancer. Inclusion into prediction models did not result in accurate leakage prediction, but high degrees of systemic inflammation might still be important in clinical decision-making. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00384-023-04496-5. Springer Berlin Heidelberg 2023-07-20 2023 /pmc/articles/PMC10359376/ /pubmed/37470911 http://dx.doi.org/10.1007/s00384-023-04496-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
Golshani, Parisa
Park, Jennifer
Häggström, Jenny
Segelman, Josefin
Matthiessen, Peter
Lydrup, Marie-Louise
Rutegård, Martin
The modified Glasgow Prognostic Score indicates an increased risk of anastomotic leakage after anterior resection for rectal cancer
title The modified Glasgow Prognostic Score indicates an increased risk of anastomotic leakage after anterior resection for rectal cancer
title_full The modified Glasgow Prognostic Score indicates an increased risk of anastomotic leakage after anterior resection for rectal cancer
title_fullStr The modified Glasgow Prognostic Score indicates an increased risk of anastomotic leakage after anterior resection for rectal cancer
title_full_unstemmed The modified Glasgow Prognostic Score indicates an increased risk of anastomotic leakage after anterior resection for rectal cancer
title_short The modified Glasgow Prognostic Score indicates an increased risk of anastomotic leakage after anterior resection for rectal cancer
title_sort modified glasgow prognostic score indicates an increased risk of anastomotic leakage after anterior resection for rectal cancer
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10359376/
https://www.ncbi.nlm.nih.gov/pubmed/37470911
http://dx.doi.org/10.1007/s00384-023-04496-5
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