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Colorectal Dis. 2018 Jan;20(1):26-34. doi: 10.1111/codi.13807.

Prediction of outcome after curative surgery for colorectal cancer: preoperative haemoglobin, C-reactive protein and albumin.

Author information

1
Center for Digestive Diseases, P9:03, Karolinska University Hospital, Solna, Sweden.
2
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
3
Functional Area of Emergency Medicine Huddinge, C1:63, Karolinska University Hospital, Stockholm, Sweden.
4
Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
5
Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.

Abstract

AIM:

The aim was to evaluate a scoring system using the values of preoperative haemoglobin, C-reactive protein (CRP) and albumin to predict colorectal cancer recurrence and survival.

METHOD:

Data on all curative resections for Stages I-III colorectal cancer performed at a tertiary referral hospital in 2007-2010 were recorded in the Swedish Colorectal Cancer Registry and were matched to local databases for laboratory results and blood transfusion. Patients who died within 30 days or during primary hospital admission were excluded. Preoperative haemoglobin, CRP and albumin levels were recorded for 417 patients. A score (0-3) was derived on the presence of anaemia (Hb < 120 g/l for women and < 130 g/l for men), raised CRP (> 10 mg/ml) and low albumin (< 35 g/dl). The risks for recurrence and impaired overall survival were assessed using Cox regression analyses.

RESULTS:

Impaired overall survival was found when one, two or three of the criteria anaemia, elevated CRP and low albumin were present prior to surgery [hazard ratio (HR) 3.61, 95% CI 1.66-7.85; HR 3.91, 95% CI 1.75-8.74; HR 4.85, 95% CI 2.15-10.93, respectively]. The risk for recurrence, however, was not related to the presence of these criteria.

CONCLUSION:

Overall survival after curative surgery for Stages I-III colorectal cancer is impaired when anaemia, elevated CRP or low albumin exist prior to surgery.

KEYWORDS:

CRP; Colorectal cancer; albumin; anaemia; recurrence; survival

PMID:
28685921
DOI:
10.1111/codi.13807
[Indexed for MEDLINE]

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