Complete Blood Count Alterations Prior to the Diagnosis of Colorectal Cancer May Help in the Detection of Synchronous Liver Metastases

Rafael J Sala; John Ery; David Cuesta-Peredo; Vicente Muedra; Vicent Rodilla

doi:10.3390/jcm12206540

Complete Blood Count Alterations Prior to the Diagnosis of Colorectal Cancer May Help in the Detection of Synchronous Liver Metastases

J Clin Med. 2023 Oct 15;12(20):6540. doi: 10.3390/jcm12206540.

Authors

Rafael J Sala^{1

2}, John Ery³, David Cuesta-Peredo⁴, Vicente Muedra^{2

5}, Vicent Rodilla⁶

Affiliations

¹ Department of General and Digestive Surgery, La Ribera University Hospital, 46600 Alzira, Spain.
² Department of Medicine and Surgery, Faculty of Health Sciences, CEU Cardenal Herrera University, CEU Universities, C/Santiago Ramón y Cajal, s/n., Alfara del Patriarca, 46115 Valencia, Spain.
³ RiskLab, ETH Zürich, 8092 Zürich, Switzerland.
⁴ Department of Quality Management, La Ribera University Hospital, 46600 Alzira, Spain.
⁵ Department of Anesthesiology, Critical Care and Pain Therapy, La Ribera University Hospital, 46600 Alzira, Spain.
⁶ Department of Pharmacy, Faculty of Health Sciences, CEU Cardenal Herrera University, CEU Universities, C/Santiago Ramón y Cajal, s/n., Alfara del Patriarca, 46115 Valencia, Spain.

Abstract

Background and Aims: Colorectal cancer (CRC) represents 10% of all cancers worldwide with the highest incidence in developed countries; its incidence is also increasing in middle- and low-income countries. Population screening programs facilitate early diagnosis of the disease. When the diagnosis is carried out in advanced stages, approximately 80% of patients with liver metastases (LM) are considered unresectable at the time of diagnosis. In our study, variations in blood counts prior to CRC diagnosis were analyzed to assess whether they could be useful in identifying smaller, more manageable metastases at earlier stages for more effective treatment. Methods: A study was carried out using complete blood counts (CBCs) from CRC patients, obtained from primary health centers and the La Ribera University Hospital within La Ribera Health Department, Valencian Community, Spain, between July 2012 and September 2020. Data from CRC patients who presented synchronous liver metastasis (CRLM) were compared with those with CRC without LM at diagnosis (CRC patients). Results: Our analysis shows that at least 15 months before CRC diagnosis, a progressive alteration was observed in CBC parameters in both groups. A higher incidence of anemia (p < 0.001) was observed among CRLM patients in the three months prior to CRC diagnosis than in CRC patients showing no LM. Conclusions: A statistically significant deterioration of CBC was observed in patients with advanced-stage CRC and synchronous or early LM (CRLM) in the three months prior to diagnosis. The primary goal of incorporating CBC variations into predictive models is to identify individuals who are at a greater risk of developing metastatic colon cancer, leading to early diagnosis. Our research improves these models by highlighting a more pronounced and rapid decline in hemoglobin levels among CRLM patients. Identification of metastases at an earlier stage when they are smaller, more manageable, and more amenable to treatment may be a valuable tool to prevent their further progression.

Keywords: colorectal cancer; complete blood count; predictive models; synchronous liver metastases.

Grants and funding

This research received no external funding.