PTH-332 Pre-operative inflammatory cell ratios (NLR and PLR) predict post-operative complications and poor outcomes following surgery for rectal cancer

Abstract

Introduction Elevated post-operative inflammatory ratios have been associated with complications following colorectal surgery, and a reduction in cancer specific survival. 1,2 No studies have previously evaluated the value of pre-operative inflammatory ratios in predicting post-operative complications Method Consecutive rectal cancer resections in a tertiary referral centre were evaluated using prospectively maintained clinical databases, and review of clinical notes if required. Patients with post-operative septic complications (n = 54; 17=anastomotic leak; 13=flap/perineal wound complication; 21=pelvic collection; 3=wound complication/other) were compared to those with no such complications (controls; n = 161). Neutrophil-(NLR) and platelet-(PLR) lymphocyte ratios, C-reactive protein (CRP), haemoglobin and albumin were recorded pre- and post-operatively in each case, along with demographic and disease-specific data. Normally distributed data were compared with t-tests and expressed as mean [standard error of mean]. Non-parametric data were analysed using Mann-Whitney U tests (median [inter-quartile range]), and proportions compared with Fisher’s exact test. Correlations were assessed using Pearson’s correlation coefficient Results Mean age at surgery was similar between groups (66 vs. 68 [controls] years; p=NS). Mean pre-operative PLR was significantly higher in the complication group (269.2 [22.8] vs. 186.3 [6.8]; p Conclusion Pre-operative elevation of inflammatory cell ratios (NLR and PLR) are novel predictors of post-operative complications following surgery for rectal cancer, and may also predict poor cancer-specific outcomes. This data suggests that tumour biology holds an important influence over complications rather than technical factors alone Disclosure of interest None Declared. References Cook EJ, Walsh SR, et al . Int J Surg. 2007;5(1):27–30 Proctor MJ, Morrison DS, et al . Eur J Cancer 2011;47(17):2633–41