The impact of the surgical Apgar score on oncological outcomes in patients with colorectal cancer: a propensity score-matched study.
Cancer-specific survival
Colorectal cancer
Postoperative complications
Prognosis
Surgical Apgar score
Journal
World journal of surgical oncology
ISSN: 1477-7819
Titre abrégé: World J Surg Oncol
Pays: England
ID NLM: 101170544
Informations de publication
Date de publication:
10 Mar 2022
10 Mar 2022
Historique:
received:
28
10
2021
accepted:
28
02
2022
entrez:
11
3
2022
pubmed:
12
3
2022
medline:
15
3
2022
Statut:
epublish
Résumé
The surgical Apgar score (SAS) predicts postoperative complications (POCs) following gastrointestinal surgery. Recently, the SAS was reported to be a predictor of not only POCs but also prognosis. However, the impact of the SAS on oncological outcomes in patients with colorectal cancer (CRC) has not been fully examined. The present study therefore explored the oncological significance of the SAS in patients with CRC, using a propensity score matching (PSM) method. We retrospectively analyzed 639 patients who underwent radical surgery for CRC. The SAS was calculated based on three intraoperative parameters: estimated blood loss, lowest mean arterial pressure, and lowest heart rate. All patients were classified into 2 groups based on the SAS (≤6 and >6). The association of the SAS with the recurrence-free survival (RFS), overall survival (OS), and cancer-specific survival (CSS) was analyzed. After PSM, each group included 156 patients. Univariate analyses revealed that a lower SAS (≤6) was significantly associated with a worse OS and CSS. A multivariate analysis revealed that the age ≥75 years old, ASA-Physical Status ≥3, SAS ≤6, histologically undifferentiated tumor type, and an advanced pStage were independent factors for the OS, and open surgery, a SAS ≤6, histologically undifferentiated tumor type and advanced pStage were independent factors for the CSS. A lower SAS (≤6) was an independent prognostic factor for not only the OS but also the CSS in patients with CRC, suggesting that the SAS might be a useful biomarker predicting oncological outcomes in patients with CRC.
Sections du résumé
BACKGROUND
BACKGROUND
The surgical Apgar score (SAS) predicts postoperative complications (POCs) following gastrointestinal surgery. Recently, the SAS was reported to be a predictor of not only POCs but also prognosis. However, the impact of the SAS on oncological outcomes in patients with colorectal cancer (CRC) has not been fully examined. The present study therefore explored the oncological significance of the SAS in patients with CRC, using a propensity score matching (PSM) method.
METHODS
METHODS
We retrospectively analyzed 639 patients who underwent radical surgery for CRC. The SAS was calculated based on three intraoperative parameters: estimated blood loss, lowest mean arterial pressure, and lowest heart rate. All patients were classified into 2 groups based on the SAS (≤6 and >6). The association of the SAS with the recurrence-free survival (RFS), overall survival (OS), and cancer-specific survival (CSS) was analyzed.
RESULTS
RESULTS
After PSM, each group included 156 patients. Univariate analyses revealed that a lower SAS (≤6) was significantly associated with a worse OS and CSS. A multivariate analysis revealed that the age ≥75 years old, ASA-Physical Status ≥3, SAS ≤6, histologically undifferentiated tumor type, and an advanced pStage were independent factors for the OS, and open surgery, a SAS ≤6, histologically undifferentiated tumor type and advanced pStage were independent factors for the CSS.
CONCLUSIONS
CONCLUSIONS
A lower SAS (≤6) was an independent prognostic factor for not only the OS but also the CSS in patients with CRC, suggesting that the SAS might be a useful biomarker predicting oncological outcomes in patients with CRC.
Identifiants
pubmed: 35272672
doi: 10.1186/s12957-022-02545-x
pii: 10.1186/s12957-022-02545-x
pmc: PMC8908623
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
75Informations de copyright
© 2022. The Author(s).
Références
Dev Cell. 2018 Apr 9;45(1):33-52.e12
pubmed: 29634935
Niger J Clin Pract. 2020 Nov;23(11):1514-1516
pubmed: 33221774
J Cachexia Sarcopenia Muscle. 2014 Jun;5(2):95-104
pubmed: 24627226
CA Cancer J Clin. 2021 May;71(3):209-249
pubmed: 33538338
Cancer Metastasis Rev. 2020 Jun;39(2):535-552
pubmed: 32152913
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
J Am Coll Surg. 2007 Feb;204(2):201-8
pubmed: 17254923
Sci Rep. 2018 Sep 6;8(1):13345
pubmed: 30190571
Eur J Heart Fail. 2016 Dec;18(12):1524-1534
pubmed: 27910284
Ann Surg. 2012 Jun;255(6):1126-8
pubmed: 22498893
Surgery. 2010 Sep;148(3):559-66
pubmed: 20227100
Ann Surg. 2009 Aug;250(2):187-96
pubmed: 19638912
Jpn J Clin Oncol. 2019 Apr 1;49(4):321-328
pubmed: 30608547
Am Surg. 2021 Aug 16;:31348211038576
pubmed: 34396795
Ann Surg Oncol. 2017 Dec;24(13):3934-3946
pubmed: 28986819
Int J Clin Oncol. 2015 Apr;20(2):207-39
pubmed: 25782566
Ann Surg. 2005 Sep;242(3):326-41; discussion 341-3
pubmed: 16135919
Ann Surg Oncol. 2016 Dec;23(Suppl 5):757-763
pubmed: 27557829
J Pers Med. 2019 Feb 07;9(1):
pubmed: 30736475
Clin Epidemiol. 2013 Nov 01;5(Suppl 1):65-74
pubmed: 24227924
J Clin Oncol. 2016 Mar 10;34(8):843-53
pubmed: 26811529
Rev Esp Enferm Dig. 2012 Dec;104(11):572-7
pubmed: 23368648
Ann Surg. 2007 Dec;246(6):1047-51
pubmed: 18043109
J Clin Oncol. 2009 Jul 1;27(19):3109-16
pubmed: 19451431
Int J Colorectal Dis. 2020 Mar;35(3):413-422
pubmed: 31897647
Dis Colon Rectum. 2019 Mar;62(3):286-293
pubmed: 30540662
Chin J Cancer. 2016 Apr 11;35:38
pubmed: 27067550
J Clin Oncol. 2011 Apr 10;29(11):1465-71
pubmed: 21383294
Ann Surg. 2009 May;249(5):727-34
pubmed: 19387333