Procalcitonin and C-reactive protein as early markers of anastomotic leakage in intestinal resections for advanced ovarian cancer (EDMOCS)

José Luis Sánchez-Iglesias ^1,2, Clara Morales-Coma ³, Lucas Minig ^4,5

¹Department of Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain.
²Biomedical Research Group in Gynecology, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.
³Breast Pathology Unit, Vall d'Hebron University Hospital, Barcelona, Spain.
⁴Department of Gynecologic Oncology, IMED Hospital, Valencia, Spain.
⁵Department of Gynecology, CEU Cardenal Herrera University, Valencia, Spain.
⁶Department of Gynecologic Oncology, La Fe University Hospital, Valencia, Spain.
⁷Gynecological Cancer Multidisciplinary Unit, Hospital del Mar, Barcelona, Spain.
⁸Department of Gynecology, Universitat Pompeu Fabra, Barcelona, Spain.
⁹Oncologic Gynecology Unit, Department of Gynecology, La Paz University Hospital, Madrid, Spain.
¹⁰Department of Gynecologic Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain.
¹¹Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery, Hospital General Universitario de Castellon, Castellón, Spain.
¹²Department of Medicine, Universidad Jaume I, Castellón, Spain.
¹³Department of Gynecologic Oncology, Hospital Universitario Donostia, OSI Donostialde, Donostia, Spain.
¹⁴Department of Biochemistry, Vall d'Hebron University Hospital, Barcelona, Spain.

⁰Department of Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain.

Acta Obstetricia Et Gynecologica Scandinavica +

|

March 27, 2024

View abstract on PubMed

Summary

Serum procalcitonin and C-reactive protein (CRP) can help detect anastomotic leakage after ovarian cancer surgery. Optimal detection occurs on postoperative day 1 for procalcitonin and day 3 for CRP.

Area Of Science

Oncology
Surgical Gastroenterology
Biomarker Discovery

Background

Anastomotic leakage is a risk after colorectal and ovarian cancer surgery.
Limited data exists on predicting leakage in advanced ovarian cancer (AOC) patients with bowel resection.
Procalcitonin and C-reactive protein (CRP) are established biomarkers for colorectal surgery complications.

Purpose Of The Study

To evaluate procalcitonin and CRP as predictive biomarkers for anastomotic leakage in AOC patients undergoing bowel resection.
To determine optimal postoperative reference values for these markers.
To identify the best postoperative day for assessing these biomarkers.

Main Methods

A prospective, observational, multicentric trial involving 92 AOC patients undergoing debulking surgery with bowel resection.
Measurement of procalcitonin and CRP levels on baseline and postoperative days 1-6.
Receiver operating characteristic (ROC) analysis to assess predictive values and determine optimal cutoff points.

Main Results

Anastomotic leakage occurred in 6.5% of patients.
Procalcitonin and CRP levels were significantly higher in patients with leakage.
Postoperative day 1 procalcitonin (AUC=0.823, cutoff 3.8 ng/mL) and day 3 CRP (AUC=0.833, cutoff 30.5 mg/dL) showed strong predictive value.

Conclusions

Procalcitonin and CRP show potential as early detection biomarkers for anastomotic leakage post-AOC surgery with bowel resection.
These markers may aid in timely clinical intervention.
Larger prospective studies are recommended for validation.

Keywords:

anastomotic leakage colorectal resection ovarian cancer