Comparative Analysis of Preoperative Ratio Based Markers in Predicting Postoperative Infectious Complications After...

Area of Science:

• Oncology
• Surgical Outcomes
• Inflammatory Markers

Background:

• Postoperative infections (POIs) significantly complicate recovery, delay treatment, and worsen long-term outcomes in gastric cancer patients.
• Accurate prediction of POIs is crucial for optimizing patient management and improving surgical outcomes.
• Ratio-based preoperative laboratory parameters offer a potential avenue for predicting POIs.

Purpose of the Study:

• To evaluate and compare the predictive capabilities of four preoperative ratio-based parameters for identifying patients at risk of POIs following D2 gastrectomy for gastric cancer.
• To identify independent risk factors associated with POIs in this patient cohort.

Main Methods:

• Retrospective analysis of 293 patients undergoing curative D2 gastrectomy.
• Utilized receiver operating characteristic (ROC) curve analysis to assess the predictive power of neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), and CRP-albumin ratio (CAR).
• Determined cutoff points for each index and performed multivariate analysis to identify independent risk factors.

Main Results:

• POIs occurred in 26.2% of patients, who also had higher Charlson Comorbidity Index (CCI) scores and longer hospital stays.
• ROC analysis indicated that NLR, LMR, and CAR were significant predictors of POI, while PLR was not.
• LMR demonstrated the highest predictive accuracy for POI. Multivariate analysis identified CCI score ≥3, NLR > 3.8, and LMR < 2.34 as independent risk factors.

Conclusions:

• Preoperative LMR is the most effective predictor of POIs after D2 gastrectomy for gastric cancer.
• CAR and NLR also show predictive value, though LMR is superior. PLR has no predictive capacity.
• Increased comorbidity (CCI ≥3) is an independent risk factor for POIs.