Preoperative Inflammatory Status and Postoperative Morbidity in Patients With Primary Retroperitoneal Sarcoma

IF 2.9 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2025-03-02 DOI:10.1002/cam4.70588

Pia van der Laan, Fabio Tirotta, Stijn van der Burg, Stefanie Hakkesteegt, Max L. Almond, Yvonne Schrage, Anant Desai, Winette T. A. van der Graaf, Dirk J. Grunhagen, Samuel J. Ford, Cornelis Verhoef, Winan J. van Houdt

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Abstract

Background

The role of preoperative inflammatory markers in predicting postoperative outcomes has been investigated in different types of cancer. However, little is known about retroperitoneal sarcoma (RPS). This study aimed to evaluate the association between preoperative inflammatory status and major postoperative morbidity in patients undergoing RPS surgery.

Methods

Data on patients undergoing surgery for primary RPS between 2008 and 2022 at three specialist sarcoma centers were analyzed. The preoperative inflammatory status was evaluated, assessing the C-reactive protein (CRP) value, the neutrophil/lymphocyte ratio (NLR), and the platelet/lymphocyte ratio (PLR). The primary outcome was 90-day major postoperative morbidity. The best-balanced cutoff values to apply in the uni- and multivariable analysis were calculated using a receiver operating characteristic (ROC) curve analysis.

Results

Data were available for 239 patients. Major postoperative complications occurred in 52 of 235 patients (22.1%). Increased median values of CRP, NLR, and PLR were significantly higher in patients with dedifferentiated liposarcoma (DDLPS) (p < 0.001). As such, further analysis focused only on this specific histotype. On multivariable analysis, after adjusting for potential confounders, the association between increasing CRP and NLR with 90-day major postoperative morbidity remained significant, with an OR of 2.96 (95% CI: 1.03–8.49, p = 0.044) for CRP > 61 mg/L, and with an OR of 4.69 (1.55–14.20, p = 0.006) for NLR > 4.85.

Conclusion

Elevated preoperative levels of CRP and NLR are independently associated with major postoperative morbidity in patients affected by primary retroperitoneal DDLPS. These findings may help decision-making and optimize perioperative management in these patients.

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.