The Postoperative C-Reactive Protein Level Is an Early Predictor of Infectious Complications after Gastric Cancer Resection]

The aim of this studywas to investigate whether postoperative serum C-reactive protein(CRP)levels can be used to predict the risk of postoperative infections in patients undergoing gastric cancer resection.Data from 77 patients who had undergone open gastrectomyfor gastric cancer between 2008 and 2014 were retrospectivelycollected. Clinical details including postoperative white blood cell(WBC)count, CRP levels, and platelet(Plt)counts were obtained. The occurrence of complications as defined bythe Clavien-Dindo classification was the outcome, particularlyanastomotic leakage or pancreatic fistula. The diagnostic accuracywas determined bymeasuring the area under the receiver operating characteristic( ROC)curve.The overall incidence of anastomotic leakage or pancreatic fistula was 9.1%. Using CRP on POD 3 had superior diagnostic accuracyfor anastomotic leakage or pancreatic fistula(area under the curve[AUC]: 0.898, 95%CI: 0.809-0.987). A cut off of 20.1mg/dL for the CRP level on POD 3 yielded a sensitivity of 85.7% and a negative predictive value of 98.3%for the detection of anastomotic leakage or pancreatic fistula.Elevated CRP levels on POD 3 may help physicians predict the occurrence of postoperative complications after gastric cancer resection, particularly anastomotic leakage and pancreatic fistula.