Role of Inflammatory and Prognostic Markers and Its Outcome Among Patients with Pre and Post-Operative Colorectal Carcinoma

Markers and Outcomes in Colorectal Carcinoma

Authors

  • Suhail Raza Department of General Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
  • Amir Iqbal Memon Department of General Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
  • Aisha Masroor Bhatti Department of General Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
  • Hitesh Kumar Department of General Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
  • . Nayab Department of General Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
  • Sayed Hashim Iqbal Department of General Surgery, Bacha Khan Medical College, Mardan, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i07.1760

Keywords:

Colorectal Cancer, Inflammatory Biomarkers, Surgical Outcomes

Abstract

Colorectal carcinoma is a significant health concern, often presenting with symptoms like bleeding per rectum, mucous discharge, tenesmus, altered bowel habits, and weight loss. This study examines the influence of inflammatory and prognostic markers on the outcomes of patients undergoing per and post-operative treatment for colorectal carcinoma. Objective: To evaluate the role of inflammatory and prognostic markers on the outcomes of patients with per and post-operative colorectal carcinoma. Methods: This cross-sectional study included 112 patients aged 20-60 years, of either gender, with symptoms such as bleeding per rectum, mucous discharge, tenesmus, altered bowel habits, and weight loss for ≥1 month, diagnosed with colorectal cancer regardless of stage and grade. Results: The mean age of the patients was 45.16 ± 10.52 years, with 51.8% males and 48.2% females. Common symptoms included abdominal pain, per rectal bleeding, and weight loss, with 89.3% presenting with anemia. Tumors were located in the colon (84.8%) and rectum (28.6%). Pre-operative markers showed elevated WBC in 59.8%, CRP in 87.5%, decreased serum albumin in 77.7%, raised ESR in 61.6%, ferritin in 65.2%, and LDH in 60.7%. Post-operative markers indicated elevated WBC in 92.9%, CRP in 94.6%, decreased serum albumin in 82.1%, raised ESR in 68.8%, ferritin in 69.6%, and LDH in 73.2%. Complications included wound infection, pneumonia, sepsis, and prolonged hospital stays, with a mortality rate of 3.6%. Conclusions: Serum inflammatory markers significantly influence prognoses and predict adverse outcomes in patients undergoing surgical treatment for colorectal carcinoma.

References

Wong MC, Huang J, Lok V, Wang J, Fung F, Ding H et al. Differences in incidence and mortality trends of colorectal cancer worldwide based on sex, age, and anatomic location. Clinical Gastroenterology and Hepatology. 2021 May; 19(5): 955-66. doi: 10.1016/j.cgh.2020.02.026. DOI: https://doi.org/10.1016/j.cgh.2020.02.026

Hossain MS, Karuniawati H, Jairoun AA, Urbi Z, Ooi DJ, John A et al. Colorectal cancer: a review of carcinogenesis, global epidemiology, current challenges, risk factors, preventive and treatment strategies. Cancers. 2022 Mar; 14(7): 1732. doi: 10.3390/cancers14071732. DOI: https://doi.org/10.3390/cancers14071732

Haas S, Mikkelsen AH, Kronborg CJ, Oggesen BT, Møller PF, Fassov J et al. Management of treatment‐related sequelae following colorectal cancer. Colorectal Disease. 2023 Mar; 25(3): 458-88. doi: 10.1111/codi.16299. DOI: https://doi.org/10.1111/codi.16299

Abbass MA and Abbas MA. Preoperative workup, staging, and treatment planning of colorectal cancer. Digestive Disease Interventions. 2023 Mar; 7(01): 003-9. doi: 10.1055/s-0043-1760733. DOI: https://doi.org/10.1055/s-0043-1760733

Hayman AV and Vasilevsky CA. Colorectal Cancer: Preoperative Evaluation and Staging. The ASCRS Textbook of Colon and Rectal Surgery. 2022: 429-50. doi: 10.1007/978-3-030-66049-9_24. DOI: https://doi.org/10.1007/978-3-030-66049-9_24

Piotrowski I, Kulcenty K, Suchorska W. Interplay between inflammation and cancer. Reports of Practical Oncology and Radiotherapy. 2020 Apr; 25(3): 422-7. doi: 10.1016/j.rpor.2020.04.004. DOI: https://doi.org/10.1016/j.rpor.2020.04.004

Amin MN, Siddiqui SA, Ibrahim M, Hakim ML, Ahammed MS, Kabir A et al. Inflammatory cytokines in the pathogenesis of cardiovascular disease and cancer. SAGE Open Medicine. 2020 Oct; 8: 2050312120965752. doi: 10.1177/2050312120965752. DOI: https://doi.org/10.1177/2050312120965752

Agharokh L, Mamola K, Yu AG, Medina AL, Gurram B, Fuller J et al. Cachexia, chorea, and pain in chronic nonbacterial osteitis and inflammatory bowel disease: a case report. Journal of Medical Case Reports. 2023 May; 17(1): 237. doi: 10.1186/s13256-023-03894-1. DOI: https://doi.org/10.1186/s13256-023-03894-1

Sadiq IZ, Usman A, Muhammad A, Ahmad KH. Sample size calculation in biomedical, clinical and biological sciences research. Journal of Umm Al-Qura University for Applied Sciences. 2024 Jun: 1-9. doi: 10.1007/s43994-024-00153-x. DOI: https://doi.org/10.1007/s43994-024-00153-x

Schneider AM, Özsoy M, Zimmermann FA, Feichtinger RG, Mayr JA, Kofler B, Sperl W, Weghuber D, Mörwald K. Age‐Related Deterioration of Mitochondrial Function in the Intestine. Oxidative Medicine and Cellular Longevity. 2020;2020(1):4898217. https://doi.org/10.1155/2020/4898217 DOI: https://doi.org/10.1155/2020/4898217

Wang Z, Gong C, Zhang Y, Wang M, Chao C, Qian Y et al. Clinical Features, Treatment Modalities, and Outcomes of Elderly Thymoma Patients: A Propensity-Matched Study Based on the SEER Database. Oncology Research and Treatment. 2023 Dec; 46(12): 522-32. doi: 10.1159/000535020. DOI: https://doi.org/10.1159/000535020

Walrath T, Dyamenahalli KU, Hulsebus HJ, McCullough RL, Idrovo JP, Boe DM, McMahan RH, Kovacs EJ. Age-related changes in intestinal immunity and the microbiome. Journal of Leucocyte Biology. 2021 Jun;109(6):1045-61. https://doi.org/10.1002/JLB.3RI0620-405RR DOI: https://doi.org/10.1002/JLB.3RI0620-405RR

Hua H, Jiang Q, Sun P, Xu X. Risk factors for early-onset colorectal cancer: systematic review and meta-analysis. Frontiers in Oncology. 2023 May; 13: 1132306. doi: 10.3389/fonc.2023.1132306. DOI: https://doi.org/10.3389/fonc.2023.1132306

Yancik R, Wesley MN, Ries LA, Havlik RJ, Long S, Edwards BK et al. Comorbidity and age as predictors of risk for early mortality of male and female colon carcinoma patients: a population‐based study. Cancer: Interdisciplinary International Journal of the American Cancer Society. 1998 Jun; 82(11): 2123-34. doi: 10.1002/(SICI)1097-0142(19980601)82:11<2123::AID-CNCR6>3.0.CO;2-W. DOI: https://doi.org/10.1002/(SICI)1097-0142(19980601)82:11<2123::AID-CNCR6>3.0.CO;2-W

Chen H, Zheng X, Zong X, Li Z, Li N, Hur J, Fritz CD, Chapman Jr W, Nickel KB, Tipping A, Colditz GA. Metabolic syndrome, metabolic comorbid conditions and risk of early-onset colorectal cancer. Gut. 2021 Jun 1;70(6):1147-54. https://doi.org/10.1136/gutjnl-2020-321661 DOI: https://doi.org/10.1136/gutjnl-2020-321661

Lee SF, Yip PL, Vellayappan BA, Chee CE, Wong LC, Wan EY et al. Incident Cardiovascular Diseases Among Survivors of High-Risk Stage II-III Colorectal Cancer: A Cluster-Wide Cohort Study. Journal of the National Comprehensive Cancer Network. 2022 Oct; 20(10): 1125-33. Doi: 10.6004/jnccn.2022.7042. DOI: https://doi.org/10.6004/jnccn.2022.7042

Zhang X, Wong VW, Yip TC, Tse YK, Liang LY, Hui VW et al. Colonoscopy and risk of colorectal cancer in patients with nonalcoholic fatty liver disease: a retrospective territory‐wide cohort study. Hepatology Communications. 2021 Jul; 5(7): 1212-23. doi: 10.1002/hep4.1705. DOI: https://doi.org/10.1002/hep4.1705

Fowler H, Belot A, Ellis L, Maringe C, Luque-Fernandez MA, Njagi EN et al. Comorbidity prevalence among cancer patients: a population-based cohort study of four cancers. BioMed Central Cancer. 2020 Dec; 20: 1-5. doi: 10.1186/s12885-019-6472-9. DOI: https://doi.org/10.1186/s12885-019-6472-9

Ottaiano A, Santorsola M, Circelli L, Perri F, Cascella M, Sabbatino F et al. Hypertension, type 2 diabetes, obesity, and p53 mutations negatively correlate with metastatic colorectal cancer patients' survival. Frontiers in Medicine. 2023 Jan; 10: 1091634. doi: 10.3389/fmed.2023.1091634. DOI: https://doi.org/10.3389/fmed.2023.1091634

Gausman V, Dornblaser D, Anand S, Hayes RB, O'Connell K, Du M et al. Risk factors associated with early-onset colorectal cancer. Clinical Gastroenterology and Hepatology. 2020 Nov; 18(12): 2752-9. doi: 10.1016/j.cgh.2019.10.009. DOI: https://doi.org/10.1016/j.cgh.2019.10.009

Low EE, Demb J, Liu L, Earles A, Bustamante R, Williams CD et al. Risk factors for early-onset colorectal cancer. Gastroenterology. 2020 Aug; 159(2): 492-501. doi: 10.1053/j.gastro.2020.01.004. DOI: https://doi.org/10.1053/j.gastro.2020.01.004

Vissers PA, Thong MS, Pouwer F, Creemers GJ, Slooter GD, van de Poll-Franse LV. Prospectively measured lifestyle factors and BMI explain differences in health-related quality of life between colorectal cancer patients with and without comorbid diabetes. Supportive Care in Cancer. 2016 Jun; 24: 2591-601. doi: 10.1007/s00520-015-3052-7. DOI: https://doi.org/10.1007/s00520-015-3052-7

Gomez D, Jimenez‐Fonseca P, Fernández AM, Castellanos PC, Arbizu MV, Cabañes RM, Estellés DL, Ferreira E, Del Rio J, García TG, Carmona‐Bayonas A. Impact of obesity on quality of life, psychological distress, and coping on patients with colon cancer. The oncologist. 2021 May 1;26(5):e874-82. https://doi.org/10.1002/onco.13687 DOI: https://doi.org/10.1002/onco.13687

Abualkhair WH, Zhou M, Ahnen D, Yu Q, Wu XC, Karlitz JJ. Trends in incidence of early-onset colorectal cancer in the United States among those approaching screening age. Journal of the American Medical Association Network Open. 2020 Jan; 3(1): e1920407-. doi: 10.1001/jamanetworkopen.2019.20407. DOI: https://doi.org/10.1001/jamanetworkopen.2019.20407

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Published

2024-07-31
CITATION
DOI: 10.54393/pjhs.v5i07.1760
Published: 2024-07-31

How to Cite

Raza, S., Memon, A. I., Bhatti, A. M., Kumar, H., Nayab, ., & Iqbal, S. H. (2024). Role of Inflammatory and Prognostic Markers and Its Outcome Among Patients with Pre and Post-Operative Colorectal Carcinoma: Markers and Outcomes in Colorectal Carcinoma. Pakistan Journal of Health Sciences, 5(07), 67–72. https://doi.org/10.54393/pjhs.v5i07.1760

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