Relationship of short-course preoperative radiotherapy and serum albumin level with postoperative complications in rectal cancer surgery
Background/Aim. The identification of risk factors could play a role in improving early postoperative outcome for rectal cancer surgery patients. The aim of this study was to determine the relationship between short-course preoperative radiotherapy (RT), serum albumin level and the developm...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Military Health Department, Ministry of Defance, Serbia
2015-01-01
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| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501400057T.pdf |
| Summary: | Background/Aim. The identification of risk factors could play a role in
improving early postoperative outcome for rectal cancer surgery patients.
The aim of this study was to determine the relationship between short-course
preoperative radiotherapy (RT), serum albumin level and the development of
postoperative complications in patients after anterior rectal resection due
to rectal cancer without creation of diverting stoma. Methods. This
retrospective study included patients with histopathologically confirmed
adenocarcinoma of the rectum by and the clinical stage of T2-T4 operated on
between 2007 and 2012. All the patients underwent open anterior rectal
resection with no diverting stoma creation. Preoperative serum albumin was
measured in each patient. Tumor location was noted intraoperatively as the
distance from the inferior tumor margin to the anal verge. Tumor size was
measured and noted by the pathologist who assessed specimens. Some of the
patients received short-course preoperative RT, and some did not. The
patients were divided into two groups (group 1 with short-course
preoperative RT, group 2 with no short-course preoperative RT).
Postoperative complications included clinically apparent anastomotic
leakage, wound infection, diffuse peritonitis and pneumonia. They were
compared between the groups, in relation to preoperative serum albumin
level, patients age, tumor size and location. Results. The study included
107 patients (51 in the group 1 and 56 in the group 2). There were no
significant difference in age (p = 0.95), and gender (p = 0.12) and tumor
distance from anal verge (p = 0.53). The size of rectal carcinoma was
significantly higher in the group 1 than in the group 2 (51.37 ± 12.04 mm vs
45.57 ± 9.81 mm, respectively; p = 0.007). The preoperative serum albumin
level was significantly lower in the group 1 than in the group 2 (34.80 ±
2.85 g/L vs 37.55 ± 2.74 g/L, respectively; p < 0.001). A significant
correlation between the tumor size and the serum albumin level was found (p
= 0.042). Overall, postoperative complications were observed in 13 (25.5%)
patients in the group 1 and in 10 (17.8%) patients in the group 2 with
significant difference between the groups (p = 0.18). A significantly lower
level of serum albumin was found in patients postoperative complications and
in those who died. A significant difference in anastomotic leakage
occurrence between groups was also found (p = 0.039). Male gender and the
lower level of serum albumin were significant predictors for anastomotic
leakage occurrence (p = 0.05 and p = 0.002, respectively), but preoperative
RT had no significant impact on it. Conclusions. A lower serum albumin
level, but not short-course of preoperative RT, was significantly associated
with postoperative complications development after rectal resection with no
diverting stoma. |
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| ISSN: | 0042-8450 2406-0720 |