YAMAGUCHI SHIGEKI
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor and Division head
Article types Original article
Language English
Peer review Non peer reviewed
Title C-reactive protein adjusted for body mass index as a predictor of postoperative complications following laparoscopic gastrectomy for gastric cancer.
Journal Formal name:Langenbeck's archives of surgery
Abbreviation:Langenbecks Arch Surg
ISSN code:14352451/14352443
Domestic / ForeginForegin
Volume, Issue, Page 406(6),pp.1875-1884
Author and coauthor Matsui Kazuaki, Sakuramoto Shinichi, Sugita Hirofumi, Nishibeppu Keiji, Ebara Gen, Fujita Shohei, Fujihata Shiro, Oya Shuichiro, Miyawaki Yutaka, Sato Hiroshi, Yamaguchi Shigeki, Yamashita Keishi
Publication date 2021/09
Summary PURPOSE:This study aimed to clarify the relationship between obesity and postoperative C-reactive protein (CRP) and assess the usefulness of obesity status-adjusted CRP levels for predicting early complications following laparoscopic gastrectomy for gastric cancer.METHODS:This study retrospectively analyzed 527 patients who underwent laparoscopic gastrectomy for gastric cancer between January 2013 and March 2019. Patients were classified into three groups according to body mass index (BMI): BMI < 20; BMI ≥ 20 to < 25; and BMI ≥ 25. The correlation between BMI and perioperative CRP was investigated in 447 patients, excluding 80 with postoperative complications. The optimal CRP cutoff value of Clavien-Dindo (CD) grade ≥ 3 for predicting severe complications for each group was determined.RESULTS:BMI was significantly correlated with CRP on postoperative day (POD) 3 (p < 0.001) in 447 patients without complications. According to the receiver operating characteristic curve analysis, CRP cutoff values on POD 3 for predicting severe complications were 92.4, 111.1, and 171.9 in the BMI < 20, BMI ≥ 20 to < 25, and BMI ≥ 25 groups, respectively. In multivariate analysis for CD grade ≥ 3 complications, cardiac history and POD 3 CRP levels higher than the adjusted cutoff were identified as independent factors significantly associated with severe complications (p = 0.021 and 0.015, respectively).CONCLUSION:CRP cutoff values on POD 3 adjusted for BMI were useful for predicting severe complications in gastrectomy for gastric cancer.
DOI 10.1007/s00423-021-02200-1
PMID 34021415