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C-Reactive Protein to Albumin Ratio: A Reliable Marker in Gastric Cancer Surgery

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Abstract

We aim to evaluate the association between elevated postoperative C-reactive protein to albumin ratio (CAR) and major complications in gastric cancer patients. A retrospective review was made of 177 patients who underwent a curative resection due to gastric cancer between 2013 and 2018. The cut-off level for CAR on postoperative 3rd day was determined based on a receiver operating characteristic (ROC) curve analysis. The ROC curve analysis determined an optimal cut-off level of 5 g/dl (AUC, 0.680; p = 0.001). The rate of postoperative complications was higher in patients with a CRP value of ≥5 g/dl (61.02%) (p < 0.001). Major complications occurred in 23 patients (38.98%) with a CAR of ≥ 5 g/dl on postoperative day 3 (p < 0.001). In addition, CAR was found to be higher in patients with longer operation durations and length of hospital stay (p = 0.046 and p < 0.001, respectively). Postoperative complications can be prevented in a timely manner, morbidity rates can be reduced, and thereby, patient quality of life can be improved by determining CAR in the early period.

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Authors and Affiliations

  1. Gastrointestinal Surgery, Kartal Kosuyolu High Education and Research Hospital, Istanbul, Turkey

    Ozlem Zeliha Sert, Hilmi Bozkurt, Ibrahim Can Bulut, Orhan Uzun, Selcuk Gulmez & Mustafa Duman

Authors
  1. Ozlem Zeliha Sert
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  2. Hilmi Bozkurt
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  3. Ibrahim Can Bulut
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  4. Orhan Uzun
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  5. Selcuk Gulmez
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  6. Mustafa Duman
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Contributions

Sert OZ designed the study, wrote the project, and drafted and revised the manuscript. Bozkurt H conceptualized, recruited, and enrolled patients; collected data; and maintained study database. Bulut CI recruited and enrolled patients, collected data and maintained study database, performed statistical analyses, and interpreted the data. Uzun O Gulmez S performed data analysis and interpreted the data and critically revised the manuscript for publication. Duman M assisted with study design; searched literature, data analysis, and interpretation; and critically revised the manuscript for publication. Material preparation, data collection, and analysis were performed by Hilmi Bozkurt, Can Ibrahim Bulut, Orhan Uzun, Selcuk Gulmez, and Mustafa Duman. All authors contributed to the study conception and design. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ozlem Zeliha Sert.

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Conflict of Interest

The authors declares that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Ethical Approval

The ethics committee of the hospital granted an approval for the study (decision number: 2019.4/14-191), and the study was conducted in accordance with the principles of the Declaration of Helsinki (revised in 2013).

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What we already know/what this article adds?

Nowadays, major complications after oncologic surgery is a big problem all over the world. Especially, these complications have caused increasing hospital costs, prolong hospitalization, impair the quality of life of the patient and result in a poor prognosis. In our department, we investigated major complications after gastric cancer surgery. Plenty of score systems have been defined to estimate postoperative complications in the early period. But we do not have the accurate ratio and/or score system yet. So, we aimed to contribute literature with our research about this issue.

When we reviewed your journal, we found that this type of work has not been published before, we are eagerly awaiting your valuable suggestions and comments.

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Cite this article

Sert, O.Z., Bozkurt, H., Bulut, I.C. et al. C-Reactive Protein to Albumin Ratio: A Reliable Marker in Gastric Cancer Surgery. Indian J Surg 83, 92–99 (2021). https://doi.org/10.1007/s12262-020-02310-y

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  • DOI: https://doi.org/10.1007/s12262-020-02310-y

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