Pretreatment albumin and leukocytes levels maybe useful as markers of postoperative complications in colorectal patients cancer: a retrospective cohort study

Abstract

Purpose: The aim of the study was to investigate whether the use of nutritional status assessment tools and markers of systemic inflammation are capable of predicting postoperative complications for surgical patients with colorectal cancer. Methods: A retrospective cohort study was performed with 673 surgical colorectal cancer patients registered in an oncology reference center from January 2008 to December 2013. Data on sociodemographic, clinical and tumor characteristics, nutritional status, T stage, lymph node involvement, blood count cells, and occurrence of postoperative complications were collected. Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and lymphocyte to monocyte ratio (LMR) were calculated. Univariate and multivariate analysis logistic regression was performed using a 95% confidence interval. Statistical significance was defined as p-value <0.05. All analyses were performed using SPSS 22.0. Results: Elevated leukocyte levels (≥9410 unit/μl; OR:2.76, 95% CI:1.22-6.27, p=0.015) and low values of albumin (≤3.7g/dl; OR:2.35, 95% CI:1.05-5.24, p=0.037) were independent factors to increase the risk for postoperative complications. Body mass index (BMI), Patient-generated subjective global assessment (PG-SGA) and Weight loss tool did not present statistically significant difference. Conclusion: Elevated leukocyte levels and low values of albumin increased independently the risk for postoperative complications. Such data could be useful in the definition of clinical protocols.