Wang Y, Wang C, Guo H, Wang SH, Chen FF, Chen QX, Zhou K. Evaluation and analysis of neurocognitive dysfunction in patients with colorectal cancer after radical resection: A retrospective study. World J Gastrointest Surg 2024; 16(9): 2893-2901 [PMID: 39351576 DOI: 10.4240/wjgs.v16.i9.2893]
Corresponding Author of This Article
Kai Zhou, PhD, Doctor, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Bengbu Medical University, No. 287 Changhuai Road, Bengbu 233000, Anhui Province, China. oakman4202@sina.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Sep 27, 2024; 16(9): 2893-2901 Published online Sep 27, 2024. doi: 10.4240/wjgs.v16.i9.2893
Evaluation and analysis of neurocognitive dysfunction in patients with colorectal cancer after radical resection: A retrospective study
Yu Wang, Chao Wang, Han Guo, Su-Hang Wang, Fang-Fang Chen, Qiao-Xiang Chen, Kai Zhou
Yu Wang, Chao Wang, Han Guo, Su-Hang Wang, Fang-Fang Chen, The Four Branches of General Surgery, The First Affiliated Hospital of Bengbu Medical University, Bengbu 233000, Anhui Province, China
Qiao-Xiang Chen, Department of Anorectal Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310030, Zhejiang Province, China
Kai Zhou, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Bengbu Medical University, Bengbu 233000, Anhui Province, China
Author contributions: Wang Y wrote the manuscript; Wang C, Guo H, Wang SH, Chen FF and Chen QX collected the data; Zhou K guided the study; All authors reviewed, edited, and approved the final manuscript and revised it critically for important intellectual content, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.
Institutional review board statement: This study was approved by the Second Affiliated Hospital of Zhejiang University School of Medicine, No. ZJJC18021102.
Informed consent statement: This study has obtained informed consent and signed treatment consent from patients and their families.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Statistical analysis plan, informed consent form, and clinical study report will also be shared if requested. Emails could be sent to the address oakman4202@sina.com to obtain the shared data.
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: Kai Zhou, PhD, Doctor, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Bengbu Medical University, No. 287 Changhuai Road, Bengbu 233000, Anhui Province, China. oakman4202@sina.com
Received: June 6, 2024 Revised: July 31, 2024 Accepted: August 14, 2024 Published online: September 27, 2024 Processing time: 104 Days and 2.7 Hours
Abstract
BACKGROUND
With the continuous progress of colorectal cancer treatment technology, the survival rate of patients has improved significantly, but the problem of postoperative neurocognitive dysfunction has gradually attracted attention.
AIM
To analyze the risk factors for delayed postoperative neurocognitive recovery (DNR) after laparoscopic colorectal cancer surgery and constructed a risk prediction model to provide an evidence-based reference for the prevention and treatment of DNR after laparoscopic colorectal cancer surgery.
METHODS
The clinical data of 227 patients with colorectal cancer who underwent laparoscopic surgery and regional cerebral saturation oxygenation (rScO2) monitoring at our hospital from March 2020 to July 2022 were retrospectively analyzed. Common factors and potential factors affecting postoperative DNR were used as analysis variables, and univariate analysis and multifactor analysis were carried out step by step to determine the predictors of the model and construct a risk prediction model. The predictive performance of the model was assessed by the receiver operating characteristic (ROC) curve, the calibration curve was used to assess the fit of the model to the data, and a nomogram was drawn. In addition, 30 patients who met the inclusion and exclusion criteria from January 2023 to July 2023 were selected for external verification of the prediction model.
RESULTS
The incidence of postoperative DNR in the modeling group was 15.4% (35/227). Multivariate analysis revealed that age, years of education, diabetes status, and the lowest rScO2 value were the independent influencing factors of postoperative DNR (all P < 0.05). Accordingly, a DNR risk prediction model was constructed after laparoscopic colorectal cancer surgery. The area under the ROC curve of the model was 0.757 (95%CI: 0.676-0.839, P < 0.001), and the Hosmer-Lemeshow test of the calibration curve suggested that the model was well fitted (P = 0.516). The C-index for external validation of the row was 0.617.
CONCLUSION
The DNR risk prediction model associated with rScO2 monitoring can be used for individualized assessment of patients undergoing laparoscopic colorectal cancer surgery and provides a clinical basis for the prevention of DNR after surgery.
Core Tip: This study evaluated and analyzed the neurocognitive dysfunction of patients after radical resection of colorectal cancer, and systematically reviewed and analyzed the changes of neurocognitive function and related influencing factors of patients after radical resection of colorectal cancer. Through the preoperative and postoperative cognitive function assessment, the purpose is to reveal the incidence of postoperative neurocognitive dysfunction and its potential mechanism, and provide scientific basis and guidance for clinical intervention and rehabilitation treatment.
