Prognostic impact of postoperative fixed‐point inflammation in patients with gastric cancer after curative gastrectomy: A validation cohort study

Abstract Background This study aimed to determine the cutoff values of C‐reactive protein (CRP) on postoperative day 3 to predict poor overall survival (OS) in men and women with gastric cancer after radical gastrectomy. Methods This retrospective cohort study included consecutive patients who under...

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Main Authors: Ryota Matsui, Manabu Ohashi, Motonari Ri, Rie Makuuchi, Tomoyuki Irino, Masaru Hayami, Takeshi Sano, Souya Nunobe
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:Annals of Gastroenterological Surgery
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Online Access:https://doi.org/10.1002/ags3.70006
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author Ryota Matsui
Manabu Ohashi
Motonari Ri
Rie Makuuchi
Tomoyuki Irino
Masaru Hayami
Takeshi Sano
Souya Nunobe
author_facet Ryota Matsui
Manabu Ohashi
Motonari Ri
Rie Makuuchi
Tomoyuki Irino
Masaru Hayami
Takeshi Sano
Souya Nunobe
author_sort Ryota Matsui
collection DOAJ
description Abstract Background This study aimed to determine the cutoff values of C‐reactive protein (CRP) on postoperative day 3 to predict poor overall survival (OS) in men and women with gastric cancer after radical gastrectomy. Methods This retrospective cohort study included consecutive patients who underwent radical gastrectomy for primary pStages I–III gastric cancer between May 2006 and March 2017. The patients were randomly divided 6:4 into a training set, which examined the cutoff values for CRP, and a validation set, which validated the cutoff values. Patients with a CRP level higher than the cutoff value were defined as the high‐CRP group, and those with a CRP level lower than the cutoff value were defined as the low‐CRP group. We compared the OS of the high and low CRP groups using the log‐rank test and identified prognostic factors using Cox proportional hazards regression analysis. Results We examined the cutoff values of CRP, which were 19.1 mg/dL for men and 8.1 mg/dL for women. The median follow‐up duration was 66 months. The high‐CRP group had poorer OS than the low‐CRP group (p < 0.001). Multivariate analyses showed that a high CRP level was an independent poor prognostic factor for OS in all patients (hazard ratio, 1.356; 95% confidence interval, 1.168–1.576; p < 0.001), not only in patients without postoperative complications (p = 0.001) but also in patients with postoperative complications (p = 0.023). Conclusion This study demonstrated that a high postoperative CRP was an independent poor prognostic factor for OS in patients with gastric cancer after radical gastrectomy.
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spelling doaj-art-700705f2a2e14c01a018d9bca02c85242025-08-20T03:30:55ZengWileyAnnals of Gastroenterological Surgery2475-03282025-07-019469871010.1002/ags3.70006Prognostic impact of postoperative fixed‐point inflammation in patients with gastric cancer after curative gastrectomy: A validation cohort studyRyota Matsui0Manabu Ohashi1Motonari Ri2Rie Makuuchi3Tomoyuki Irino4Masaru Hayami5Takeshi Sano6Souya Nunobe7Department of Gastroenterological Surgery The Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo JapanDepartment of Gastroenterological Surgery The Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo JapanDepartment of Gastroenterological Surgery The Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo JapanDepartment of Gastroenterological Surgery The Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo JapanDepartment of Gastroenterological Surgery The Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo JapanDepartment of Gastroenterological Surgery The Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo JapanDepartment of Gastroenterological Surgery The Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo JapanDepartment of Gastroenterological Surgery The Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo JapanAbstract Background This study aimed to determine the cutoff values of C‐reactive protein (CRP) on postoperative day 3 to predict poor overall survival (OS) in men and women with gastric cancer after radical gastrectomy. Methods This retrospective cohort study included consecutive patients who underwent radical gastrectomy for primary pStages I–III gastric cancer between May 2006 and March 2017. The patients were randomly divided 6:4 into a training set, which examined the cutoff values for CRP, and a validation set, which validated the cutoff values. Patients with a CRP level higher than the cutoff value were defined as the high‐CRP group, and those with a CRP level lower than the cutoff value were defined as the low‐CRP group. We compared the OS of the high and low CRP groups using the log‐rank test and identified prognostic factors using Cox proportional hazards regression analysis. Results We examined the cutoff values of CRP, which were 19.1 mg/dL for men and 8.1 mg/dL for women. The median follow‐up duration was 66 months. The high‐CRP group had poorer OS than the low‐CRP group (p < 0.001). Multivariate analyses showed that a high CRP level was an independent poor prognostic factor for OS in all patients (hazard ratio, 1.356; 95% confidence interval, 1.168–1.576; p < 0.001), not only in patients without postoperative complications (p = 0.001) but also in patients with postoperative complications (p = 0.023). Conclusion This study demonstrated that a high postoperative CRP was an independent poor prognostic factor for OS in patients with gastric cancer after radical gastrectomy.https://doi.org/10.1002/ags3.70006C‐reactive proteingastrectomyinflammationpostoperative complicationsstomach neoplasms
spellingShingle Ryota Matsui
Manabu Ohashi
Motonari Ri
Rie Makuuchi
Tomoyuki Irino
Masaru Hayami
Takeshi Sano
Souya Nunobe
Prognostic impact of postoperative fixed‐point inflammation in patients with gastric cancer after curative gastrectomy: A validation cohort study
Annals of Gastroenterological Surgery
C‐reactive protein
gastrectomy
inflammation
postoperative complications
stomach neoplasms
title Prognostic impact of postoperative fixed‐point inflammation in patients with gastric cancer after curative gastrectomy: A validation cohort study
title_full Prognostic impact of postoperative fixed‐point inflammation in patients with gastric cancer after curative gastrectomy: A validation cohort study
title_fullStr Prognostic impact of postoperative fixed‐point inflammation in patients with gastric cancer after curative gastrectomy: A validation cohort study
title_full_unstemmed Prognostic impact of postoperative fixed‐point inflammation in patients with gastric cancer after curative gastrectomy: A validation cohort study
title_short Prognostic impact of postoperative fixed‐point inflammation in patients with gastric cancer after curative gastrectomy: A validation cohort study
title_sort prognostic impact of postoperative fixed point inflammation in patients with gastric cancer after curative gastrectomy a validation cohort study
topic C‐reactive protein
gastrectomy
inflammation
postoperative complications
stomach neoplasms
url https://doi.org/10.1002/ags3.70006
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