Identification of multiple risk factors for colorectal cancer relapse after laparoscopic radical resection

ARTICLE HIGHLIGHTS

Research background

Colorectal cancer (CRC) is a prevalent and life-threatening disease that often necessitates surgical intervention, such as laparoscopic radical resection. However, despite successful surgical procedures, a subset of patients experiences relapse. The identification of risk factors associated with CRC relapse is crucial for guiding clinical interventions and enhancing patient outcomes. This study aimed to conduct a comparative analysis of baseline data and laboratory indicators in CRC patients to determine the risk factors contributing to relapse following laparoscopic radical resection. A retrospective analysis was performed on 140 CRC patients, of which 30 experienced relapse within three years after surgery. The study revealed that tumors located in the rectum with low differentiation and lymphatic vessel invasion were associated with higher relapse rates. Additionally, specific serum markers, including CD4⁺/CD8⁺ ratio, immunoglobulins (Ig) IgA, IgG, IgM, albumin-globulin ratio (AGR), neutrophils to lymphocytes ratio (NLR), cytokeratin 19 fragment antigen 21-1 (CYFRA 21-1), vascular endothelial growth factor (VEGF), and the inflammatory biomarker Chitinase-3-like protein 1 (YKL-40), were identified as independent risk factors for CRC relapse. These findings underscore the importance of monitoring these factors to reduce the risk of disease recurrence and improve patient outcomes.

Research motivation

CRC is a significant health burden with the potential for relapse even after successful surgical intervention. The identification of risk factors associated with CRC relapse is crucial to guide clinical interventions and enhance patient outcomes. This study aimed to analyze the baseline data and laboratory indicators of CRC patients who underwent laparoscopic radical resection, with the objective of determining the risk factors contributing to relapse. The findings highlighted several key factors, including tumor location, differentiation, lymphatic vessel invasion, as well as serum markers such as CD4⁺/CD8⁺ ratio, IgG, IgA, IgM, AGR, NLR, CYFRA21-1, VEGF, and YKL-40. Understanding these risk factors can aid in identifying high-risk patients and implementing proactive measures for monitoring and intervention, ultimately reducing the risk of relapse and improving the long-term survival prospects for CRC patients.

Research objectives

This study aimed to compare baseline data and laboratory indicators of CRC patients who underwent laparoscopic radical resection to identify risk factors associated with CRC relapse. The objectives were to determine the differences in tumor characteristics, analyze serum markers, assess statistical significance, identify independent risk factors using logistic regression, and provide insights for clinical monitoring and interventions to reduce relapse risk and improve patient outcomes.

Research methods

This study utilized a retrospective analysis of baseline data from 140 CRC patients admitted to the hospital between January 2018 and January 2020. The included subjects were followed up until death or a maximum of three years. Comparative analysis was conducted to compare the baseline data and laboratory indicators between patients who experienced relapse and those who did not. Tumor characteristics, including location, differentiation, and lymphatic vessel invasion, were assessed. Serum markers, such as CD4⁺/CD8⁺ ratio, IgG, IgA, IgM, AGR, NLR, CYFRA21-1, VEGF, and YKL-40, were measured and compared between the relapse and non-relapse groups. Statistical analyses were performed to determine the significance of the observed differences. Logistic regression was employed to identify independent risk factors associated with CRC relapse after laparoscopic radical surgery. The research methods aimed to provide valuable insights into the identification and monitoring of risk factors for disease recurrence and improving patient survival outcomes.

Research results

Out of the 140 CRC patients included in the study, 30 cases (21.43%) experienced relapse within three years after laparoscopic radical resection, while 110 patients (78.57%) did not relapse. The relapse group exhibited a higher frequency of tumors located in the rectum with low differentiation and lymphatic vessel invasion compared to the non-relapse group. Significant differences were observed in the levels of several serum markers. The relapse group showed lower expressions of CD4⁺/CD8⁺ ratio, IgG, IgA, IgM, AGR, and PNI. Conversely, the relapse group had higher levels of NLR, CYFRA21-1, VEGF, and YKL-40. Logistic regression analysis confirmed that all these altered factors were independent risk factors for CRC relapse following laparoscopic radical surgery, with odds ratios greater than 1 and statistically significant values (P < 0.05). These findings emphasize the importance of monitoring these factors for reducing disease recurrence and improving patient survival outcomes.

Research conclusions

Based on our comparative analysis of baseline data and laboratory indicators in CRC patients who underwent laparoscopic radical resection, we have identified several important conclusions. Firstly, tumors located in the rectum with low differentiation and lymphatic vessel invasion are associated with a higher risk of relapse after surgery. Additionally, lower levels of CD4⁺/CD8⁺ ratio, IgG, IgA, IgM, AGR, and PNI, along with higher levels of NLR, CYFRA21-1, VEGF, and YKL-40, serve as independent risk factors for CRC relapse following surgery. These findings highlight the significance of monitoring these factors to guide clinical interventions and reduce the risk of disease recurrence. By focusing on these risk factors, healthcare professionals can enhance patient surveillance and develop strategies to improve survival outcomes in CRC patients undergoing laparoscopic radical resection.

Research perspectives

The identification of multiple risk factors for CRC relapse following laparoscopic radical surgery provides valuable insights into improving patient outcomes. Moving forward, prospective studies should focus on validating these findings in larger patient populations and diverse healthcare settings. Further investigations can explore the molecular mechanisms underlying the identified risk factors to gain a deeper understanding of their roles in disease recurrence. Additionally, the development of predictive models incorporating these risk factors could aid in personalized treatment strategies and postoperative surveillance. Long-term follow-up studies are warranted to assess the impact of monitoring these factors on long-term survival and quality of life in CRC patients. Furthermore, intervention studies targeting modifiable risk factors may offer potential avenues for reducing disease relapse rates. Overall, continued research efforts in this field will contribute to optimizing clinical management and ultimately enhancing the prognosis of CRC patients undergoing laparoscopic radical resection.