Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jun 15, 2022; 14(6): 1199-1209
Published online Jun 15, 2022. doi: 10.4251/wjgo.v14.i6.1199
Does chronic kidney disease affect the complications and prognosis of patients after primary colorectal cancer surgery?
Xiao-Yu Liu, Bin Zhang, Yu-Xi Cheng, Wei Tao, Chao Yuan, Zheng-Qiang Wei, Dong Peng
Xiao-Yu Liu, Bin Zhang, Yu-Xi Cheng, Wei Tao, Chao Yuan, Zheng-Qiang Wei, Dong Peng, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Author contributions: Liu XY and Bin Zhang are co-first authors; Liu XY and Zhang B contributed to data extraction; Peng D contributed to quality assessments and writing-origin draft; Peng D and Liu XY contributed to data analysis; Peng D, Liu XY, Zhang B, Cheng YX, Tao W, Yuan C, and Wei ZQ contributed to writing-review and editing; The final manuscript was read and approved by all of our authors.
Conflict-of-interest statement: The authors declare that they have no competing interests.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Dong Peng, PhD, Doctor, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1 Yuanjia Gangyouyi Road, Chongqing 400016, China.
Received: December 27, 2021
Peer-review started: December 27, 2021
First decision: March 13, 2022
Revised: March 26, 2022
Accepted: May 27, 2022
Article in press: May 27, 2022
Published online: June 15, 2022
Research background

Colorectal cancer (CRC) is the third most common malignant tumor and the second leading cause of cancer deaths worldwide. Several key pathophysiological causes of chronic kidney disease (CKD) may lead to increased postoperative morbidity, including excessive arterial calcification, endothelial dysfunction and increased levels of inflammatory factors. Previous studies have shown that patients with CKD might have an increased risk of CRC; however, the impact of CKD on complications and prognosis after CRC surgery is controversial.

Research motivation

The aim of this study was to conduct meta-analysis of current studies and to analyze whether CKD had specific effect on the outcomes after CRC surgery.

Research objectives

The aim of this study is to provide some recommendations for clinical work by investigating the impact of CKD on postoperative complications and prognosis in colorectal cancer.

Research methods

We searched the PubMed, Embase, Cochrane Library databases and CNKI, from inception to March 14, 2022. Newcastle-Ottawa Scale was used for the quality assessment in this meta-analysis, and we used RevMan 5.3 was used for data analysis.

Research results

A total of nine studies including 47771 patients were included in this meta-analysis. No significant difference was found in terms of overall postoperative complications. We analyzed the specific complications and found that the CKD group had higher rates of pulmonary infection, cardiovascular complications and short-term death. After pooling the hazard ratios, the CKD group had worse overall survival (OS).

Research conclusions

Preexisting CKD was associated with higher rates of pulmonary infection, higher rates of short-term death, and worse OS and poorer disease-free survival (DFS) following CRC surgery.

Research perspectives

Based on the results and limitations of this research, multicenter, high-quality and well-controlled prospective studies including comprehensive baseline information comparing the complications, OS, DFS and CSS should be performed in the future.