Colorectal cancer (CRC) is one the most common type of cancer worldwide. Surgery remains the only potentially curative treatment option for it. Despite recent medical progress, postoperative complications still occur in about 40-50% of CRC patients [1]. There is a lack of tools that could reliably predict postoperative complications before the surgery. Therefore, this study aims to investigate a variety of biomarkers for postoperative outcomes after left-side CRC surgery.
In this prospective longitudinal study, 40 patients undergoing left-side CRC surgery were included. Blood samples were collected on the baseline, postoperative day 6 and 30. ELISA and RT-qPCR were performed to evaluate 13 serum cytokines and 2 plasma miRNAs expression as biomarkers for postoperative outcomes. Univariate and multivariate logistic regression analyses were performed to adjust for common risk factors (age, gender, CCI, TNF-α, IL-8, tumor size, lymph node status, white blood cells and c-reactive protein concentration).
Patients who suffered postoperative complications (n = 16; 40%) were found to have an increased baseline serum median of TNF-α (50.39; IQR = 2.37–590.50 pg/mL vs 2.28; IQR = 2.28–14.16 pg/mL, p = 0.009) and IL-8 (15.88; IQR = 5.16–49.96 pg/mL vs 7.06; IQR = 3.84–13.26 pg/mL, p = 0.031). At univariate analysis, TNF-α, gender and CCI were identified as potential risk factors associated with postoperative complications (p < 0.1). Multivariate analysis confirmed a higher than 2.47 TNF-α level (OR = 15.97; 95% CI 2.30–337.13, p = 0.018) and male gender (OR = 9.48; CI 1.44–189.46, p = 0.047) as risk factors for postoperative complications after CRC resections. Results presented here suggest, that serum TNF-α could be used to identify high-risk surgical CRC patients.
In conclusion, our study demonstrated that patients with an increased TNF-α level are at a higher risk for postoperative complications after left-side CRC surgery.