ArticleColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland2022
C-reactive protein (CRP) trajectory as a predictor of anastomotic leakage after rectal cancer resection: A multicentre cohort study.
Article in Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 17 citations in OpenAlex.
- Development and validation of an interpretable machine learning model for predicting postoperative complications after transanal total mesorectal excision: a multicenter study.Techniques in coloproctology · 2026Article
- Early C-reactive protein as a predictive biomarker for postoperative complications following robot-assisted surgery for rectal cancer.Updates in surgery · 2026Article
- Diagnostic accuracy of C-reactive protein in detecting anastomotic leakage after minimally invasive rectal cancer surgery.Surgical endoscopy · 2026Article
- Machine Learning Models Using Post-operative CRP Trends to Predict Colorectal Anastomotic Leak: A Pilot Study.Cureus · 2025Article
- Identification of postoperative complications in sigmoid colon cancer and rectal cancer using the C-reactive protein level.Surgical endoscopy · 2025Article
- Comparison of drain displacement and complications between conventional drain insertion and extraperitoneal tunneling drain insertion following anterior or low anterior resection: a retrospective comparative cohort study.Annals of surgical treatment and research · 2025Article
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- Clinical value of prognostic nutritional index combined with C-reactive protein and albumin in early prediction of anastomotic leakage after radical gastric cancer surgery.American journal of translational research · 2024Article
- Does computed tomography-derived volumometry and densitometry of psoas muscle really correlate with complications in rectal cancer patients after elective surgery?Journal of clinical imaging science · 2024Article
- Is early CT in cases of elevated postoperative CRP the best option for the diagnosis of colorectal anastomotic leakage?International journal of colorectal disease · 2023Article
- C-reactive protein (CRP) trajectory as a predictor of anastomotic leakage after rectal cancer resection: A multicentre cohort study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2022Article
- Machine Learning-based Correlation Study between Perioperative Immunonutritional Index and Postoperative Anastomotic Leakage in Patients with Gastric Cancer.International journal of medical sciences · 2022Article
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimThis study aimed to identify whether CRP-trajectory measurement, including increase in CRP-level of 50 mg/l per day, is an accurate predictor of anastomotic leakage (AL) in patients undergoing resection for rectal cancer.
methodsA prospective multicentre database was used. CRP was recorded on the first three postoperative days. Sensitivity, specificity, positive and negative predictive values, and area under the receiver operator characteristic (ROC) curve were used to analyse performances of CRP-trajectory measurements between postoperative day (POD) 1-2, 2-3, 1-3 and between any two days.
resultsA total of 271 patients were included in the study. AL was observed in 12.5% (34/271). Increase in CRP-level of 50 mg/l between POD 1-2 had a negative predictive value of 0.92, specificity of 0.71 and sensitivity of 0.57. Changes in CRP-levels between POD 2-3 were associated with a negative predictive value, specificity and sensitivity of 0.89, 0.93 and 0.26, respectively. Changes in CRP-levels between POD 1-3 showed a negative predictive value of 0.94, specificity of 0.76 and sensitivity of 0.65. In addition, 50 mg/l changes between any two days showed a negative predictive value of 0.92, specificity of 0.66 and sensitivity of 0.62. The area under the ROC curve for all CRP-trajectory measurements ranged from 0.593-0.700.
conclusionThe present study showed that CRP-trajectory between postoperative days lacks predictive value to singularly rule out AL. Early and safe discharge in patients undergoing rectal surgery for adenocarcinoma cannot be guaranteed based on this parameter. High negative predictive values are mainly caused by the relatively low prevalence of AL.
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