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

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.

Figure 1

Kaplan–Meier curve between preoperative total protein levels and recurrence after 24 months of follow-up.

Figure 2

Kaplan–Meier curve between preoperative glycated hemoglobin levels and recurrence after 24 months of follow-up.