Skip to main content

Advertisement

SpringerLink
Log in

The predicting value of postoperative body temperature on long-term survival in patients with rectal cancer

  • Research Article
  • Published:
Tumor Biology

Abstract

This study aimed to assess the association between postoperative body temperature and prognosis in patients with rectal cancer. Five hundred and seven patients with stage I to III rectal cancers were enrolled in the current study. Basal body temperature (BBT, measured at 6 am) and maximal body temperature (MBT) on each day after surgery were analyzed retrospectively. Patients were divided into two equal groups according to the median of BBT and MBT at each day. The primary end points were disease-free survival (DFS) and overall survival (OS). The univariate and multivariate analyses showed that patients with low D0-MBT (<37.4 °C) had lower 3-year DFS [adjusted hazard ratio (HR) 1.56 (95 % CI 1.08–2.24, P = 0.017)] as well as OS [adjusted HR 1.72 (95 % CI 1.05–2.82, P = 0.032)] rate as compared to those with high D0-MBT (>37.4 °C). In the subset of 318 patients with T3 stage tumor and the subgroup of 458 patients without blood transfusion as well, low D0-MBT continues to be an independent predictor of DFS/OS with an adjusted HR equal to 1.48 (95 % CI 1.02–2.24, P = 0.046)/1.68 (95 % CI 1.04–2.99, P = 0.048) and 1.45 (95 % CI 1.02–2.13, P = 0.048)/1.59 (95 % CI 1.01–2.74, P = 0.049), respectively. In addition, we found that patients have higher risk of 1-year recurrence if those were exhibiting low preoperative BBT (<36.6 °C) (17 vs. 10 %, P = 0.034). Low body temperature (D0-MBT < 37.4 °C) after surgery was an independent predictor of poor survival outcomes in patients with rectal cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63:11–30.

    Article  PubMed  Google Scholar 

  2. Kapiteijn E, Marijnen CA, Nagtegaal ID, Putter H, Steup WH, Wiggers T, et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med. 2001;345:638–46.

    Article  CAS  PubMed  Google Scholar 

  3. Sauer R, Becker H, Hohenberger W, Rodel C, Wittekind C, Fietkau R, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med. 2004;351:1731–40.

    Article  CAS  PubMed  Google Scholar 

  4. Komori K, Kanemitsu Y, Kimura K, Sano T, Ito S, Abe T, et al. Detailed stratification of TNM stage III rectal cancer based on the presence/absence of extracapsular invasion of the metastatic lymph nodes. Dis Colon Rectum. 2013;56:726–32.

    Article  PubMed  Google Scholar 

  5. Luo Y, Cui J, Chen C, Song S, Huang M, Peng J, et al. Clinical outcomes after surgical resection of colorectal cancer in 1,294 patients. Hepatogastroenterology. 2012;59:1398–402.

    PubMed  Google Scholar 

  6. Cho MM, Morgan JW, Knutsen R, Oda K, Shavlik D, Knutsen S, et al. Outcomes of multimodality therapies for patients with stage II or III rectal cancer in California, 1994–2009. Dis Colon Rectum. 2013;56:1357–65.

    Article  PubMed  Google Scholar 

  7. Betge J, Pollheimer MJ, Lindtner RA, Kornprat P, Schlemmer A, Rehak P, et al. Intramural and extramural vascular invasion in colorectal cancer: prognostic significance and quality of pathology reporting. Cancer. 2012;118:628–38.

    Article  PubMed  Google Scholar 

  8. Huh JW, Kim HR, Kim YJ. Lymphovascular or perineural invasion may predict lymph node metastasis in patients with T1 and T2 colorectal cancer. J Gastrointest Surg. 2010;14:1074–80.

    Article  PubMed  Google Scholar 

  9. Kalady MF, Dejulius KL, Sanchez JA, Jarrar A, Liu X, Manilich E, et al. BRAF mutations in colorectal cancer are associated with distinct clinical characteristics and worse prognosis. Dis Colon Rectum. 2012;55:128–33.

    Article  PubMed  Google Scholar 

  10. Peyrin-Biroulet L, Lepage C, Jooste V, Gueant JL, Faivre J, Bouvier AM. Colorectal cancer in inflammatory bowel diseases: a population-based study (1976–2008). Inflamm Bowel Dis. 2012;18:2247–51.

    Article  PubMed  Google Scholar 

  11. Roxburgh CS, McMillan DC. Role of systemic inflammatory response in predicting survival in patients with primary operable cancer. Futur Oncol (Lond, Engl). 2010;6:149–63.

    Article  CAS  Google Scholar 

  12. Tada N, Tsuno NH, Kawai K, Murono K, Nirei T, Ishihara S, et al. Changes in the plasma levels of cytokines/chemokines for predicting the response to chemoradiation therapy in rectal cancer patients. Oncol Rep. 2014;31:463–71.

    CAS  PubMed  Google Scholar 

  13. Koido S, Ohkusa T, Homma S, Namiki Y, Takakura K, Saito K, et al. Immunotherapy for colorectal cancer. World J Gastroenterol. 2013;19:8531–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Du G, Liu Y, Li J, Liu W, Wang Y, Li H. Hypothermic microenvironment plays a key role in tumor immune subversion. Int Immunopharmacol. 2013;17:245–53.

    Article  CAS  PubMed  Google Scholar 

  15. Moyer HR, Delman KA. The role of hyperthermia in optimizing tumor response to regional therapy. Int J Hyperth. 2008;24:251–61.

    Article  CAS  Google Scholar 

  16. Wondergem J, Stephens LC, Strebel FR, Baba H, Ohno S, Siddik ZH, et al. Effect of adriamycin combined with whole body hyperthermia on tumor and normal tissues. Cancer Res. 1991;51:3559–67.

    CAS  PubMed  Google Scholar 

  17. Calderwood SK, Theriault JR, Gong J. How is the immune response affected by hyperthermia and heat shock proteins. Int J Hyperth. 2005;21:713–6.

    Article  CAS  Google Scholar 

  18. Gunderson LL, Jessup JM, Sargent DJ, Greene FL, Stewart A. Revised tumor and node categorization for rectal cancer based on surveillance, epidemiology, and end results and rectal pooled analysis outcomes. J Clin Oncol. 2010;28:256–63.

    Article  PubMed  Google Scholar 

  19. Tiselius C, Gunnarsson U, Smedh K, Glimelius B, Pahlman L. Patients with rectal cancer receiving adjuvant chemotherapy have an increased survival: a population-based longitudinal study. Ann Oncol Off J Eur Soc Med Oncol / ESMO. 2013;24:160–5.

    Article  CAS  Google Scholar 

  20. Mercuriali F, Inghilleri G. Transfusion risks and limitations. Minerva Anestesiol. 1999;65:286–92.

    CAS  PubMed  Google Scholar 

  21. Downes K, Sarode R. Massive blood transfusion. Indian J Pediatr. 2001;68:145–9.

    Article  CAS  PubMed  Google Scholar 

  22. Busch OR, Hop WC, van Papendrecht MAH, Marquet RL, Jeekel J. Blood transfusions and prognosis in colorectal cancer. N Engl J Med. 1993;328:1372–6.

    Article  CAS  PubMed  Google Scholar 

  23. Hodgson WJ, Lowenfels AB. Blood transfusion and recurrence rates in colonic malignancy. Lancet. 1982;2:1047.

    CAS  PubMed  Google Scholar 

  24. Kluger MJ. The evolution and adaptive value of fever. Am Sci. 1978;66:38–43.

    CAS  PubMed  Google Scholar 

  25. Zhang HG, Mehta K, Cohen P, Guha C. Hyperthermia on immune regulation: a temperature’s story. Cancer Lett. 2008;271:191–204.

    Article  CAS  PubMed  Google Scholar 

  26. Vertree RA, Leeth A, Girouard M, Roach JD, Zwischenberger JB. Whole-body hyperthermia: a review of theory, design and application. Perfusion. 2002;17:279–90.

    Article  PubMed  Google Scholar 

  27. Alexander HR, Fraker DL. Treatment of peritoneal carcinomatosis by continuous hyperthermic peritoneal perfusion with cisplatin. Cancer Treat Res. 1996;81:41–50.

    Article  CAS  PubMed  Google Scholar 

  28. Chen JS, Changchien CR, Tang R. Postoperative fever and survival in patients after open resection for colorectal cancer: a long-term follow-up study of 2,311 prospectively enrolled patients. Dis Colon Rectum. 2008;51:1649–55.

    Article  PubMed  Google Scholar 

  29. Nowacki MP, Szymendera JJ. The strongest prognostic factors in colorectal carcinoma. Surgicopathologic stage of disease and postoperative fever. Dis Colon Rectum. 1983;26:263–8.

    Article  CAS  PubMed  Google Scholar 

  30. Fucini C, Bandettini L, D’Elia M, Filipponi F, Herd-Smith A. Are postoperative fever and/or septic complications prognostic factors in colorectal cancer resected for cure. Dis Colon Rectum. 1985;28:94–5.

    Article  CAS  PubMed  Google Scholar 

  31. Hafstrom L, Holmin T. Relationship between postoperative temperature and survival in patients resected for colorectal cancer. Am J Surg. 1978;135:213–4.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

Support for present study was provided by National Key Clinical Discipline, Program of Introducing Talents of Discipline to Universities of China (B12003, JW), International Science & Technology Cooperation Program of China (2011DFA32570, JW) and National Natural Science Foundation of China (81172040 JW;81201920, YL).

Conflicts of interest

None

Author information

Authors and Affiliations

  1. Department of Colon and Rectum Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, 26 Yuancun Erheng Road, Guangzhou, Guangdong, 510655, China

    Huichuan Yu, Yanxin Luo, Hui Peng, Liang Kang, Meijin Huang, Shuangling Luo, Wenhao Chen & Jianping Wang

  2. Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, 26 Yuancun Erheng Road, Guangzhou, Guangdong, 510655, China

    Yanxin Luo, Zihuan Yang & Jianping Wang

Authors
  1. Huichuan Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yanxin Luo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hui Peng
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Liang Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Meijin Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shuangling Luo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Wenhao Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Zihuan Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jianping Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jianping Wang.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Table S1

(DOCX 16 kb)

Fig. S1

Kaplan–Meier curves showed moderate-range post-oeprative fever (T >/= 38.5 °C) on day 0-7 (A&B) and antipyretic administration of NSAIDs (C&D) didn’t significantly affect three-year OS or DFS. With the combination of them, we found there was no significant difference between patients without fever and patients developing fever with or without administration of NSAIDs, in terms of OS(E) and DFS(F). (GIF 81 kb)

High resolution image (TIFF 1650 kb)

Fig. S2

Kaplan–Meier curves showed significant lower three-year OS(A) and DFS(B) rate in the low D0-MBT group as compared to those with high D0-MBT (P < 0.001) among patients without post-operative fever. (GIF 75 kb)

High resolution image (TIFF 2296 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yu, H., Luo, Y., Peng, H. et al. The predicting value of postoperative body temperature on long-term survival in patients with rectal cancer. Tumor Biol. 36, 8055–8063 (2015). https://doi.org/10.1007/s13277-015-3535-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13277-015-3535-7

Keywords

Search

Navigation