Published online Jun 15, 2022. doi: 10.4251/wjgo.v14.i6.1199
Peer-review started: December 27, 2021
First decision: March 13, 2022
Revised: March 26, 2022
Accepted: May 27, 2022
Article in press: May 27, 2022
Published online: June 15, 2022
Processing time: 164 Days and 8.7 Hours
Colorectal cancer (CRC) is the third most common malignant tumor and the second leading cause of cancer deaths worldwide. Several key pathophysiological causes of chronic kidney disease (CKD) may lead to increased postoperative morbidity, including excessive arterial calcification, endothelial dysfunction and increased levels of inflammatory factors. Previous studies have shown that patients with CKD might have an increased risk of CRC; however, the impact of CKD on complications and prognosis after CRC surgery is controversial.
The aim of this study was to conduct meta-analysis of current studies and to analyze whether CKD had specific effect on the outcomes after CRC surgery.
The aim of this study is to provide some recommendations for clinical work by investigating the impact of CKD on postoperative complications and prognosis in colorectal cancer.
We searched the PubMed, Embase, Cochrane Library databases and CNKI, from inception to March 14, 2022. Newcastle-Ottawa Scale was used for the quality assessment in this meta-analysis, and we used RevMan 5.3 was used for data analysis.
A total of nine studies including 47771 patients were included in this meta-analysis. No significant difference was found in terms of overall postoperative complications. We analyzed the specific complications and found that the CKD group had higher rates of pulmonary infection, cardiovascular complications and short-term death. After pooling the hazard ratios, the CKD group had worse overall survival (OS).
Preexisting CKD was associated with higher rates of pulmonary infection, higher rates of short-term death, and worse OS and poorer disease-free survival (DFS) following CRC surgery.
Based on the results and limitations of this research, multicenter, high-quality and well-controlled prospective studies including comprehensive baseline information comparing the complications, OS, DFS and CSS should be performed in the future.