Impact of Preoperative Total Proteins and Glycated Hemoglobin on Recurrences after Early Colorectal Cancer

Nutrients. 2021 Feb 23;13(2):711. doi: 10.3390/nu13020711.

Abstract

Background: The outcome of colorectal cancer is mostly based on TNM classification. There are several factors determining that patients with the same tumoral stage present different outcomes. The nutritional status has been related to the immunological response and may affect the oncologic results. The purpose of this study was to determine if preoperative nutritional parameters may predict the oncologic outcome in patients with early colorectal cancer.

Methods: A prospective observational study of patients undergoing elective surgery for colorectal cancer was performed with stage I. Preoperative nutritional assessment included glycemic and lipid profiles, total proteins, and albumin levels. These parameters were correlated with tumoral recurrence during a follow-up of at least 24 months.

Results: During the period of study, 744 patients were operated on and 228 (30.6%) followed the inclusion criteria for this study. Recurrence rate was 5.7% (13 patients). Patients with hypoproteinemia showed a 7.8-fold greater risk of recurrence during the first 24 months after surgery [OR 7.8 (CI95% 1.3-48), p = 0.012]. Patients with glycated hemoglobin levels (HbA1c) > 6.2% showed a 2.3 increased risk of recurrence [OR 2.3 (CI95% 1.1-4.7; p = 0.01].

Conclusions: Preoperative values of total proteins and HbA1c correlate with the recurrence rate in early colorectal cancer.

Keywords: early colorectal cancer; glycated hemoglobin; outcome; total proteins.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Blood Glucose / analysis
  • Blood Proteins / analysis*
  • Colectomy / adverse effects
  • Colorectal Neoplasms / blood*
  • Colorectal Neoplasms / complications
  • Colorectal Neoplasms / surgery
  • Female
  • Glycated Hemoglobin / analysis*
  • Humans
  • Hypoproteinemia / blood
  • Hypoproteinemia / complications
  • Lipids / blood
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / etiology*
  • Neoplasm Staging
  • Nutrition Assessment
  • Nutritional Status
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology*
  • Predictive Value of Tests
  • Preoperative Period
  • Proctectomy / adverse effects
  • Prospective Studies
  • Risk Factors
  • Treatment Outcome

Substances

  • Blood Glucose
  • Blood Proteins
  • Glycated Hemoglobin A
  • Lipids