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P0071 Faecal calprotectin as an early biomarker of colorectal anastomotic leak
Abstracts / 51 (2015) e1–e36
downstaging. Use of a multivariate analysis showed that only CEA levels (65 ng/ml) were a significant factor to predict downstaging (odds ratio 16.0, 95% CI 1.8–146.7; p = 0.014). CEA levels were found to be the only factor significantly associated with downsizing in univariate analysis. Interpretation: This study showed that pretreatment levels of serum CEA were significantly associated with both downstaging and downsizing of LARC after preoperative chemoradiotherapy. Pretreatment levels of serum CEA are valuable parameters to implement personalised treatments for patients with LARC.
http://dx.doi.org/10.1016/j.ejca.2015.06.045
P0071 FAECAL CALPROTECTIN AS AN EARLY BIOMARKER OF COLORECTAL ANASTOMOTIC LEAK E. Morandi *, M. Monteleone, D.A. Merlini, G. Vignati, T. D’Aponte, M. Castoldi. OU of General Surgery, G Salvini Hospital, Rho, Milan, Italy Background: Although the early diagnosis of an anastomotic leak is a key point in reducing its clinical consequences, in daily practice this diagnosis appears later than it should. Faecal calprotectin is a protein that binds calcium and zinc, and belongs to the S100 family expressed mainly by neutrophils, and has important extracellular activity. Faecal calprotectin is used to assess active inflammation in patients with inflammatory bowel disease and colorectal cancer. Colorectal cancer is associated with a local acute inflammatory reaction of variable intensity. Several studies have assessed the role of C-reactive protein (CRP) as an early marker of anastomotic leakage, but studies into the role of faecal calprotectin to predict anastomotic failure have never been described in scientific literature. We aimed to determine whether faecal calprotectin is a predictor of anastomotic leak in colorectal surgery. Methods: The study was performed on 100 consecutive patients with diagnosed colorectal cancer admitted to hospital for an operation. Data were collected on: demographical, surgical, ASA class, and morbidity. During the first four postoperative days, faecal calprotectin, C-reactive protein, leucocytes, haemoglobin, platelets, and vital signs were evaluated. Findings: Nine (9%) patients developed a major anastomotic leak (needing reoperation) and two patients needed abdominal drainage. 4 days after surgery faecal calprotectin was significantly higher (>300 lg/g; normal value <90 lg/g) in patients who developed anastomotic leakage than those who did not develop any complications. The association between faecal calprotectin value and a CRP cutoff value of 12 mg/dL yielded a sensitivity of 85%, a specificity of 95%, and a negative predictive value of 95% for the detection of anastomotic leakage. Interpretation: Faecal calprotectin is a predictor of major anastomotic leak after colorectal resection. If raised faecal calprotectin is reported on the fourth day after surgery a careful evaluation of the patient is necessary before discharge. The increasing association between faecal calprotectin and CRP may provide a more effective way to detect an anastomotic leak.
http://dx.doi.org/10.1016/j.ejca.2015.06.046
e15
P0072 C-REACTIVE PROTEIN 24 H AFTER COLORECTAL SURGERY AS AN EARLY PREDICTOR FOR ANASTOMOTIC LEAKAGE: A PRELIMINARY STUDY E. Morandi *, M. Monteleone, D.A. Merlini, G. Vignati, T. D’Aponte, M. Castoldi. OU of General Surgery, Azienda Ospedaliera G. Salvini, Rho, Milan, Italy Background: Anastomotic leakage represents a serious complication after colorectal surgery for cancer. The early diagnosis of anastomotic leakage is a key point in reducing its clinical consequences. Currently there are no post-surgical markers for early detection of this complication before it becomes clinically apparent. C-reactive protein (CRP) is a biomarker used to help sepsis diagnosing and monitoring antibiotic therapy. The predictive value of CRP as a marker of infective postoperative complications has been widely investigated with promising results. The aim of our study is to evaluate the predictive value of CRP in predicting anastomotic leakage. Methods: A series of 99 consecutive patients, 56 (56.56%) men and 43 (43.43%) women, who underwent elective colorectal surgery for cancer (both laparoscopic and laparotomic with primary anastomosis) were prospectively recruited. Mean age was 68 years. The following data were collected: demographical, surgical, ASA class, and morbidity. 24 h after surgical procedure was completed, the C-reactive protein, leucocytes, and vital signs were evaluated. Findings: 11 (11.11%) patients developed a major anastomotic leak (need for drainage or reoperation). CRP was significantly higher (>12 mg/dL) 24 h after surgery in patients who developed anastomotic leakage, whereas the white blood cell count was not. A CRP cutoff value of 12 mg/dL 24 h after surgery yielded a sensitivity of 80%, a specificity of 95%, and a negative predictive value of 95% for the detection of anastomotic leakage. Interpretation: This is a preliminary study and requires larger sample of patients; however, our results show that increased CRP levels 24 h after colorectal surgery may provide an effective marker to detect anastomotic leakage, before clinical symptoms appear. Moreover, normal CRP values might be also a useful marker to facilitate a safe and early discharge of selected patients after colorectal surgery. CRP is an early, sensitive, and reliable marker of anastomotic leakage. http://dx.doi.org/10.1016/j.ejca.2015.06.047
P0073 CLINICAL CHARACTERISTICS OF PROSTATE CANCER AT A TERTIARY CARE MEDICAL CENTRE IN SOUTHERN INDIA OVER 11 YEARS: A RETROSPECTIVE ANALYSIS U. Singhal *, A.K. Chawla, J. Thomas, P. Hegde. Kasturba Medical College, Manipal University, Manipal, Karnataka, India Background: Prostate cancer is the second most common contributor to the number of new cases of cancer in India. To our knowledge, little information exists regarding disease characteristics at the time of diagnosis in the Indian population. The aim of this study was to report the clinicopathological features of prostate cancer in a hospital-based population from southern India. Methods: We did a retrospective analysis of the medical records of 299 consecutive patients who had been diagnosed with prostate cancer between January 2001, and December 2011, and collected relevant data.
downstaging. Use of a multivariate analysis showed that only CEA levels (65 ng/ml) were a significant factor to predict downstaging (odds ratio 16.0, 95% CI 1.8–146.7; p = 0.014). CEA levels were found to be the only factor significantly associated with downsizing in univariate analysis. Interpretation: This study showed that pretreatment levels of serum CEA were significantly associated with both downstaging and downsizing of LARC after preoperative chemoradiotherapy. Pretreatment levels of serum CEA are valuable parameters to implement personalised treatments for patients with LARC.
http://dx.doi.org/10.1016/j.ejca.2015.06.045
P0071 FAECAL CALPROTECTIN AS AN EARLY BIOMARKER OF COLORECTAL ANASTOMOTIC LEAK E. Morandi *, M. Monteleone, D.A. Merlini, G. Vignati, T. D’Aponte, M. Castoldi. OU of General Surgery, G Salvini Hospital, Rho, Milan, Italy Background: Although the early diagnosis of an anastomotic leak is a key point in reducing its clinical consequences, in daily practice this diagnosis appears later than it should. Faecal calprotectin is a protein that binds calcium and zinc, and belongs to the S100 family expressed mainly by neutrophils, and has important extracellular activity. Faecal calprotectin is used to assess active inflammation in patients with inflammatory bowel disease and colorectal cancer. Colorectal cancer is associated with a local acute inflammatory reaction of variable intensity. Several studies have assessed the role of C-reactive protein (CRP) as an early marker of anastomotic leakage, but studies into the role of faecal calprotectin to predict anastomotic failure have never been described in scientific literature. We aimed to determine whether faecal calprotectin is a predictor of anastomotic leak in colorectal surgery. Methods: The study was performed on 100 consecutive patients with diagnosed colorectal cancer admitted to hospital for an operation. Data were collected on: demographical, surgical, ASA class, and morbidity. During the first four postoperative days, faecal calprotectin, C-reactive protein, leucocytes, haemoglobin, platelets, and vital signs were evaluated. Findings: Nine (9%) patients developed a major anastomotic leak (needing reoperation) and two patients needed abdominal drainage. 4 days after surgery faecal calprotectin was significantly higher (>300 lg/g; normal value <90 lg/g) in patients who developed anastomotic leakage than those who did not develop any complications. The association between faecal calprotectin value and a CRP cutoff value of 12 mg/dL yielded a sensitivity of 85%, a specificity of 95%, and a negative predictive value of 95% for the detection of anastomotic leakage. Interpretation: Faecal calprotectin is a predictor of major anastomotic leak after colorectal resection. If raised faecal calprotectin is reported on the fourth day after surgery a careful evaluation of the patient is necessary before discharge. The increasing association between faecal calprotectin and CRP may provide a more effective way to detect an anastomotic leak.
http://dx.doi.org/10.1016/j.ejca.2015.06.046
e15
P0072 C-REACTIVE PROTEIN 24 H AFTER COLORECTAL SURGERY AS AN EARLY PREDICTOR FOR ANASTOMOTIC LEAKAGE: A PRELIMINARY STUDY E. Morandi *, M. Monteleone, D.A. Merlini, G. Vignati, T. D’Aponte, M. Castoldi. OU of General Surgery, Azienda Ospedaliera G. Salvini, Rho, Milan, Italy Background: Anastomotic leakage represents a serious complication after colorectal surgery for cancer. The early diagnosis of anastomotic leakage is a key point in reducing its clinical consequences. Currently there are no post-surgical markers for early detection of this complication before it becomes clinically apparent. C-reactive protein (CRP) is a biomarker used to help sepsis diagnosing and monitoring antibiotic therapy. The predictive value of CRP as a marker of infective postoperative complications has been widely investigated with promising results. The aim of our study is to evaluate the predictive value of CRP in predicting anastomotic leakage. Methods: A series of 99 consecutive patients, 56 (56.56%) men and 43 (43.43%) women, who underwent elective colorectal surgery for cancer (both laparoscopic and laparotomic with primary anastomosis) were prospectively recruited. Mean age was 68 years. The following data were collected: demographical, surgical, ASA class, and morbidity. 24 h after surgical procedure was completed, the C-reactive protein, leucocytes, and vital signs were evaluated. Findings: 11 (11.11%) patients developed a major anastomotic leak (need for drainage or reoperation). CRP was significantly higher (>12 mg/dL) 24 h after surgery in patients who developed anastomotic leakage, whereas the white blood cell count was not. A CRP cutoff value of 12 mg/dL 24 h after surgery yielded a sensitivity of 80%, a specificity of 95%, and a negative predictive value of 95% for the detection of anastomotic leakage. Interpretation: This is a preliminary study and requires larger sample of patients; however, our results show that increased CRP levels 24 h after colorectal surgery may provide an effective marker to detect anastomotic leakage, before clinical symptoms appear. Moreover, normal CRP values might be also a useful marker to facilitate a safe and early discharge of selected patients after colorectal surgery. CRP is an early, sensitive, and reliable marker of anastomotic leakage. http://dx.doi.org/10.1016/j.ejca.2015.06.047
P0073 CLINICAL CHARACTERISTICS OF PROSTATE CANCER AT A TERTIARY CARE MEDICAL CENTRE IN SOUTHERN INDIA OVER 11 YEARS: A RETROSPECTIVE ANALYSIS U. Singhal *, A.K. Chawla, J. Thomas, P. Hegde. Kasturba Medical College, Manipal University, Manipal, Karnataka, India Background: Prostate cancer is the second most common contributor to the number of new cases of cancer in India. To our knowledge, little information exists regarding disease characteristics at the time of diagnosis in the Indian population. The aim of this study was to report the clinicopathological features of prostate cancer in a hospital-based population from southern India. Methods: We did a retrospective analysis of the medical records of 299 consecutive patients who had been diagnosed with prostate cancer between January 2001, and December 2011, and collected relevant data.