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01-12-2023 | Rectal Cancer | Research

Predictive value of the Naples prognostic score on postoperative outcomes in patients with rectal cancer

Authors: Atsushi Sugimoto, Tatsunari Fukuoka, Hisashi Nagahara, Masatsune Shibutani, Yasuhito Iseki, Hiroaki Kasashima, Maho Sasaki, Masaichi Ohira, Kiyoshi Maeda

Published in: Langenbeck's Archives of Surgery | Issue 1/2023

Abstract

Purpose

The Naples prognostic score (NPS) is a prognostic index based on the nutritional and inflammatory status. However, its utility in predicting postoperative complications (POCs) has not been examined in rectal cancer (RC). We evaluated the predictive value of the preoperative NPS for POCs in RC.

Methods

We retrospectively analyzed 235 patients who underwent surgery for RC. The NPS was calculated based on serum albumin, serum total cholesterol, the neutrophil-to-lymphocyte ratio (NLR) and the lymphocyte-to-monocyte ratio (LMR). Severe POCs were defined as Clavien-Dindo classification grade ≥ III. The optimal cut-off value of the NPS was determined by a receiver operator characteristic (ROC) curve analysis. The NPS, NLR, LMR, platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP)-to-albumin ratio (CAR), Glasgow prognostic score (GPS), Onodera prognostic nutritional index (PNI) and controlling nutritional status score (CONUT) were investigated as inflammation-based and/or nutritional markers. Predictors of severe POCs were analyzed by logistic regression modeling.

Results

Severe POCs were observed in 64 patients (27.2%). Male sex, operation time (> 257 min), blood loss (≥ 30 mL), albumin (< 4.0 g/dL), CRP (≥ 1.0 mg/dL), total cholesterol (≤ 180 mg/dL), NPS (≥ 2), LMR (≥ 3.48), PLR (≥ 103.6), CAR (> 0.025), GPS (≥ 1), PNI (< 48.1) and CONUT (≥ 2) were significantly associated with severe POCs. The multivariate analysis revealed that male sex, operation time (> 257 min), and a high NPS (≥ 2) were independent predictors of severe POCs. The ROC curve analysis revealed that the NPS had the greatest predictive value among the inflammation-based and/or nutritional markers.

Conclusion

The NPS is a valuable predictor of severe POCs in RC.

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Title: Predictive value of the Naples prognostic score on postoperative outcomes in patients with rectal cancer
Authors: Atsushi Sugimoto
Tatsunari Fukuoka
Hisashi Nagahara
Masatsune Shibutani
Yasuhito Iseki
Hiroaki Kasashima
Maho Sasaki
Masaichi Ohira
Kiyoshi Maeda
Publication date: 01-12-2023
Publisher: Springer Berlin Heidelberg
Keywords: Rectal Cancer
Rectal Cancer
Published in: Langenbeck's Archives of Surgery / Issue 1/2023
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-023-02851-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Predictive value of the Naples prognostic score on postoperative outcomes in patients with rectal cancer

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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