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C-reactive protein adjusted for body mass index as a predictor of postoperative complications following laparoscopic gastrectomy for gastric cancer

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Abstract

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.

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Acknowledgements

The authors thank Yayoi Hongo, a staff member at the Department of Gastroenterological Surgery in Saitama Medical University International Medical Center, for help in preparing the manuscript.

Availability of data and material

Data are not available because of ethical restrictions. Due to the nature of this research, the study participants did not agree for their data to be shared publicly, so supporting data is not available.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama, 350-1298, Japan

    Kazuaki Matsui, Shinichi Sakuramoto, Hirofumi Sugita, Keiji Nishibeppu, Gen Ebara, Shohei Fujita, Shiro Fujihata, Shuichiro Oya, Yutaka Miyawaki, Hiroshi Sato & Shigeki Yamaguchi

  2. Division of Advanced Surgical Oncology, Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Sagamihara, Japan

    Keishi Yamashita

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  1. Kazuaki Matsui
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Contributions

Study conception and design: Kazuaki Matsui, Shinichi Sakuramoto, Hirofumi Sugita, Keishi Yamashita. Acquisition of data: Kazuaki Matsui, Kenji Nishibeppu, Gen Ebara, Shohei Fujita, Shiro Fujihata, Shuichiro Oya. Analysis and interpretation of data: Kazuaki Matsui, Yutaka Miyawaki, Hiroshi Sato. Drafting of manuscript: Kazuaki Matsui. Critical revision of manuscript: Shinichi Sakuramoto, Shigeshi Yamaguchi, Keishi Yamashita

Corresponding author

Correspondence to Kazuaki Matsui.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Independent Ethics Committee of Saitama Medical University International Medical Center (19-226).

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Written informed consent was waived because of the retrospective design.

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Matsui, K., Sakuramoto, S., Sugita, H. et al. C-reactive protein adjusted for body mass index as a predictor of postoperative complications following laparoscopic gastrectomy for gastric cancer. Langenbecks Arch Surg 406, 1875–1884 (2021). https://doi.org/10.1007/s00423-021-02200-1

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