Effect of preoperative asymptomatic renal dysfunction on the clinical course after colectomy for colon cancer

Abstract

Purpose: To evaluate the effect of mild renal dysfunction on the clinical course after colectomy in patients with colon cancer.

Methods: The subjects of this retrospective study were 263 patients who underwent surgical resection for colon cancer at our hospital between 2011 and 2015. Renal function was assessed based on preoperative estimated glomerular filtration rate (eGFR) values. Patients were divided into groups based on their eGFR value of 55 ml/min/1.73 m². The Mann-Whitney U test, chi-square or Fisher exact test, and log-rank test were used in the data analysis.

Results: There were 59 patients (22.4%) in the low eGFR group and 204 patients in the normal eGFR group. There were differences between the groups in age, comorbidities, and the levels of hemoglobin, albumin, and serum creatinine. The overall postoperative complication rate, frequency of severe complications, and length of stay were significantly higher in the low eGFR group than in the normal eGFR group. Multivariate analysis revealed that low eGFR was the only independent risk factor for severe complications (Clavien-Dindo classification III/IV). There were no differences in survival between the groups.

Conclusion: Preoperative asymptomatic renal dysfunction may be correlated with the development of postoperative complications and a possible significant risk factor for severe complications after colon cancer surgery.

Keywords: Colon cancer; Estimated glomerular filtration rate; Postoperative complication; Renal dysfunction.