Perioperative risk factors for survival outcomes in elective colorectal cancer surgery: a retrospective cohort study

BMC Gastroenterology

Zhao-Qiong Zhu¹  Jun Su²  Yuan-yuan Long³  Miao He⁴  Xing-Xing Liu⁵ 

[1] Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, 149#, Dalian Road, 563000, ZunyiGuizhou Province, China;Department of Pathology, Affiliated Hospital of Zunyi Medical University, 563000, ZunyiGuizhou Province, China;Department of Pediatrics, Affiliated Hospital of Zunyi Medical University, 563000, ZunyiGuizhou Province, China;Soochow University Medical College, 215000, SuzhouJiangsu Province, China;Soochow University Medical College, 215000, SuzhouJiangsu Province, China;Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, 149#, Dalian Road, 563000, ZunyiGuizhou Province, China;

关键词: Colorectal cancer;    Colorectal cancer surgery;    Perioperative risk factors;    Survival outcome;    Sevoflurane;    High-grade inflammation;   

DOI  :  10.1186/s12876-021-01757-x

来源: Springer

【 摘 要 】

BackgroundSurgical resection remains the best option for long-term survival in colorectal cancer (CRC); however, surgery can lead to tumor cell release into the circulation. Previous studies have also shown that surgery can affect cancer cell growth. The role of perioperative factors influencing long-term survival in patients presenting for CRC surgery remains to be investigated.MethodsThis retrospective single–center cohort study was conducted to collect the clinical data of patients who underwent elective laparoscopic resection for CRC from January 2014 to December 2015, namely clinical manifestations, pathological results, and perioperative characteristics. Survival was estimated using the Kaplan–Meier log-rank test. Univariable and multivariable Cox regression models were used to compare hazard ratios (HR) for death.ResultsA total of 234 patients were eligible for analysis. In the multivariable Cox model, tumor-node-metastasis (TNM) stage (stage IV: HR 30.63, 95% confidence interval (CI): 3.85–243.65; P = 0.001), lymphovascular invasion (yes: HR 2.07, 95% CI 1.09–3.92; P = 0.027), inhalational anesthesia with isoflurane (HR 1.96, 95% CI 1.19–3.21; P = 0.008), and Klintrup–Makinen (KM) inflammatory cell infiltration grade (low-grade inflammation: HR 2.03, 95% CI 1.20–3.43; P = 0.008) were independent risk factors affecting 5-year overall survival after laparoscopic resection for CRC.ConclusionsTNM stage, lymphovascular invasion, isoflurane, and KM grade were independent risk factors affecting CRC prognosis. Sevoflurane and high-grade inflammation may be associated with improved survival in CRC patients undergoing resection.

【 授权许可】

CC BY