Surgical stress biomarkers as early predictors of postoperative infectious complications in patients with colorectal cancer

Background: The aim of this study was to determine if the serum surgical stress biomarkers tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) could predict infectious complications in patients who underwent colorectal cancer (CRC) surgery.Methods: A total of 200 consecutive patients who underwent resection for primary CRC were enrolled. The clinicopathological characteristics, serum TNF-α and IL-10 levels, and infectious complications were analyzed. The TNF-α and IL-10 levels were classified using cut-off values based on a ROC analysis.Results: Infectious complications developed in 27 (13.5%) patients. Patients with complications had higher serum IL-10 levels than those without complications during the first 5 postoperative days (PODs) (P<0.05). Preoperative TNF-α levels and those on PODs 1–3 were significantly higher in patients who experienced infectious complications than in those without complications (P<0.05). A serum IL-10 level >72.4 ng/L on POD 1, >35.3 ng/L on POD 3 or >20.3 ng/L on POD 5 was associated with the occurrence of infectious complications (all P<0.01). Similarly, a preoperative TNF-α level>6.9 ng/L and a TNF-α level >8.1 ng/L on POD 1 and >7.5 ng/L on POD 3 were confirmed as sensitive and specific predictors of complications (P<0.05).Conclusions: Serum TNF-α and IL-10 levels were associated with the development of infectious complications. These cytokines can serve as useful biomarkers for identifying perioperative morbidity and for helping to guide the postoperative management of patients undergoing CRC surgery.