Circulating metabolic markers after surgery identify patients at risk for severe postoperative complications: a prospective cohort study in colorectal cancer

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  • dc.contributor.author Montcusí Ventura, Blanca
  • dc.contributor.author Madrid-Gambin, Francisco
  • dc.contributor.author Pozo Mendoza, Óscar J., 1975-
  • dc.contributor.author Marco, Santiago
  • dc.contributor.author Marin, Silvia
  • dc.contributor.author Mayol Girbau, Xavier
  • dc.contributor.author Pascual, Marta
  • dc.contributor.author Alonso, Sandra
  • dc.contributor.author Salvans Ruiz, Silvia
  • dc.contributor.author Jiménez Toscano, Marta
  • dc.contributor.author Cascante Serratosa, Marta
  • dc.contributor.author Pera Roman, Miguel
  • dc.date.accessioned 2024-10-22T06:22:58Z
  • dc.date.available 2024-10-22T06:22:58Z
  • dc.date.issued 2024
  • dc.description.abstract Background: Early detection of postoperative complications after colorectal cancer (CRC) surgery is associated with improved outcomes. The aim was to investigate early metabolomics signatures capable to detect patients at risk for severe postoperative complications after CRC surgery. Materials and methods: Prospective cohort study of patients undergoing CRC surgery from 2015 to 2018. Plasma samples were collected before and after surgery, and analyzed by mass spectrometry obtaining 188 metabolites and 21 ratios. Postoperative complications were registered with Clavien-Dindo Classification and Comprehensive Complication Index. Results: One hundred forty-six patients were included. Surgery substantially modified metabolome and metabolic changes after surgery were quantitatively associated with the severity of postoperative complications. The strongest positive relationship with both Clavien-Dindo and Comprehensive Complication Index (β=4.09 and 63.05, P <0.001) corresponded to kynurenine/tryptophan, against an inverse relationship with lysophosphatidylcholines (LPCs) and phosphatidylcholines (PCs). Patients with LPC18:2/PCa36:2 below the cut-off 0.084 µM/µM resulted in a sevenfold higher risk of major complications (OR=7.38, 95% CI: 2.82-21.25, P <0.001), while kynurenine/tryptophan above 0.067 µM/µM a ninefold (OR=9.35, 95% CI: 3.03-32.66, P <0.001). Hexadecanoylcarnitine below 0.093 µM displayed a 12-fold higher risk of anastomotic leakage-related complications (OR=11.99, 95% CI: 2.62-80.79, P =0.004). Conclusion: Surgery-induced phospholipids and amino acid dysregulation is associated with the severity of postoperative complications after CRC surgery, including anastomotic leakage-related outcomes. The authors provide quantitative insight on metabolic markers, measuring vulnerability to postoperative morbidity that might help guide early decision-making and improve surgical outcomes. Trial registration: ClinicalTrials.gov NCT02789709.
  • dc.description.sponsorship This study was supported by research grant from Instituto de Salud Carlos III (FIS grant PI19/00643) and co-funded by the European Union. FMG was supported by Grant FJC2018-035791-I funded by MCIN/AEI/10.13039/501100011033. SM and MC were supported by Grant PID2020-115051RB-I00 funded by MCIN/AEI/10.13039/501100011033. SM and MC were supported by Grant 2017SGR1033 funded by AGAUR. MC was supported by ‘ICREA Academia’ award funded by ICREA Foundation.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Montcusí B, Madrid-Gambin F, Pozo ÓJ, Marco S, Marin S, Mayol X, et al. Circulating metabolic markers after surgery identify patients at risk for severe postoperative complications: a prospective cohort study in colorectal cancer. Int J Surg. 2024 Mar 1;110(3):1493-501. DOI: 10.1097/JS9.0000000000000965
  • dc.identifier.doi http://dx.doi.org/10.1097/JS9.0000000000000965
  • dc.identifier.issn 1743-9191
  • dc.identifier.uri http://hdl.handle.net/10230/68280
  • dc.language.iso eng
  • dc.publisher Wolters Kluwer (LWW)
  • dc.relation.ispartof Int J Surg. 2024 Mar 1;110(3):1493-501
  • dc.relation.projectID info:eu-repo/grantAgreement/ES/2PE/PID2020-115051RB-I00
  • dc.rights © Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword Colorectal cancer
  • dc.subject.keyword Metabolomics
  • dc.subject.keyword Postoperative complications
  • dc.title Circulating metabolic markers after surgery identify patients at risk for severe postoperative complications: a prospective cohort study in colorectal cancer
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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