Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2023; 15(10): 2211-2221
Published online Oct 27, 2023. doi: 10.4240/wjgs.v15.i10.2211
Identification of multiple risk factors for colorectal cancer relapse after laparoscopic radical resection
Jun Luo, Mei-Wen He, Ting Luo, Guo-Qing Lv
Jun Luo, Mei-Wen He, Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
Ting Luo, Department of Operating Room, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
Guo-Qing Lv, Department of Gastrointestinal Surgery, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
Author contributions: Luo J proposed the concept of this study; He MW contributed to data collection; Luo J and Luo T contributed to formal analysis; Lv GQ participated in the survey; Luo T contributed to these methods; Lv GQ, He MW, and Luo J guided the research; Lv GQ validated this study; Luo J contributed to the visualization of this study; Luo J wrote the first draft; All authors reviewed and edited the manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Shenzhen University Hospital.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guo-Qing Lv, MS, Attending Doctor, Department of Gastrointestinal Surgery, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Peking University Shenzhen Hospital, No. 120 Lianhua Road, Futian District, Shenzhen 518036, Guangdong Province, China. 365973269@qq.com
Received: July 18, 2023
Peer-review started: July 18, 2023
First decision: August 4, 2023
Revised: August 8, 2023
Accepted: August 18, 2023
Article in press: August 18, 2023
Published online: October 27, 2023
Processing time: 101 Days and 1.7 Hours
Abstract
BACKGROUND

Colorectal cancer (CRC) is a common life-threatening disease that often requires surgical intervention, such as laparoscopic radical resection. However, despite successful surgeries, some patients experience disease relapse. Identifying the risk factors for CRC relapse can help guide clinical interventions and improve patient outcomes.

AIM

To determine the risk factors that may lead to CRC relapse after laparoscopic radical resection.

METHODS

We performed a retrospective analysis using the baseline data of 140 patients with CRC admitted to our hospital between January 2018 and January 2020. All included participants were followed up until death or for 3 years. The baseline data and laboratory indicators were compared between the patients who experienced relapse and those who did not experienced relapse.

RESULTS

Among the 140 patients with CRC, 30 experienced relapse within 3 years after laparoscopic radical resection and 110 did not experience relapse. The relapse group had a higher frequency of rectal tumors with low differentiation and lymphatic vessel invasion than that of the non-relapse group. The expression of serum markers and the prognostic nutritional index were lower, whereas the neutrophil-to-lymphocyte ratio, expression of cytokeratin 19 fragment antigen 21-1, vascular endothelial growth factor, and Chitinase-3-like protein 1 were significantly higher in the relapse group than those in the non-relapse group. The groups did not differ significantly based on other parameters. Logistic regression analysis revealed that all the above significantly altered factors were independent risk factors for CRC relapse.

CONCLUSION

We identified multiple risk factors for CRC relapse following surgery, which can be considered for the clinical monitoring of patients to reduce disease recurrence and improve patient survival.

Keywords: Colorectal cancer; Laparoscopic surgery; Relapse; Risk factors

Core Tip: This study aimed to identify the risk factors for colorectal cancer (CRC) relapse after laparoscopic radical resection by comparing the baseline data and laboratory indicators of 140 patients with CRC, of whom 30 patients experienced relapse within 3 years. Rectal tumors with low differentiation and lymphatic vessel invasion were associated with higher relapse rates. Lower CD4+/CD8+ ratio, immunoglobulins (Ig) IgA, IgG, IgM, albumin-globulin ratio, and prognostic nutritional index and higher neutrophils to lymphocytes ratio, cytokeratin 19 fragment antigen 21-1, vascular endothelial growth factor, and Chitinase-3-like protein 1 were also identified as independent risk factors for CRC relapse following surgery. These findings suggested that monitoring these factors could reduce the risk of disease recurrence and improve patient outcomes.