Key result
Clinical prognostic variables including age, sex, diabetes, BMI, body composition, and functional status were consistently associated with short-term post-operative outcomes in colorectal cancer.
Why the study?
Surgery for colorectal cancer causes post-operative morbidity and mortality, prompting an umbrella review to synthesize evidence on factors associated with short-term complications.
What are the clinical prognostic variables affecting short-term outcomes in patients undergoing colorectal cancer surgery?
Systematic Review
What are the clinical prognostic variables affecting short-term outcomes in patients undergoing colorectal cancer surgery?
Proposes a minimum dataset of baseline variables to be included in future studies of patients undergoing colorectal cancer resection to maximize dataset benefit.
Should inform preoperative risk stratification for colorectal cancer resection; extends support for minimum baseline datasets in future studies.
INTRODUCTION: Surgery for colorectal cancer is associated with post-operative morbidity and mortality. Multiple systematic reviews have reported on individual factors affecting short-term outcome following surgical resection. This umbrella review aims to synthesize the available evidence on host and other factors associated with short-term post-operative complications. METHODS: A comprehensive search identified systematic reviews reporting on short-term outcomes following colorectal cancer surgery using PubMed, Cochrane Database of Systematic Reviews and Web of Science from inception to 8th September 2020. All reported clinicopathological variables were extracted from published systematic reviews. RESULTS: The present overview identified multiple validated factors affecting short-term outcomes in patients undergoing colorectal cancer resection. In particular, factors consistently associated with post-operative outcome differed with the type of complication; infective, non-infective or mortality. A minimum dataset was identified for future studies and included pre-operative age, sex, diabetes status, body mass index, body composition (sarcopenia, visceral obesity) and functional status (ASA, frailty). A recommended dataset included antibiotic prophylaxis, iron therapy, blood transfusion, erythropoietin, steroid use, enhance recovery programme and finally potential dataset included measures of the systemic inflammatory response CONCLUSION: A minimum dataset of mandatory, recommended, and potential baseline variables to be included in studies of patients undergoing colorectal cancer resection is proposed. This will maximise the benefit of such study datasets.
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Cheong et al. (2022) conducted a systematic review in colorectal cancer. Clinical prognostic variables was evaluated on short-term post-operative complications (infective, non-infective or mortality). Clinical prognostic variables including age, sex, diabetes, BMI, body composition, and functional status were consistently associated with short-term post-operative outcomes in colorectal cancer.
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