Early prediction of anastomotic leakage after rectal cancer surgery: Onodera prognostic nutritional index combined with inflammation-related biomarkers

作者：Ziyi Zhang, Ke-Jin Li, Xiangyue Zeng, Kuan Wang, Subinur Sulayman, Yi Chen, Zeliang Zhao · 发表于：World Journal of Gastrointestinal Surgery · 年份：2025 · DOI：10.4240/wjgs.v17.i4.102862 · 被引用次数：26 · 研究领域：Inflammatory Biomarkers in Disease Prognosis、Colorectal Cancer Surgical Treatments、Nutrition and Health in Aging

BACKGROUND Anastomotic leakage (AL) is a serious complication following rectal cancer surgery and is associated with increased recurrence, mortality, extended hospital stays, and delayed chemotherapy. The Onodera prognostic nutritional index (OPNI) and inflammation-related biomarkers, such as the neutrophil-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), have been studied in the context of cancer prognosis, but their combined efficacy in predicting AL remains unclear. AIM To investigate the relationships between AL and these markers and developed a predictive model for AL. METHODS A retrospective cohort study analyzed the outcomes of 434 patients who had undergone surgery for rectal cancer at a tertiary cancer center from 2016 to 2023. The patients were divided into two groups on the basis of the occurrence of AL: One group consisted of patients who experienced AL (n = 49), and the other group did not (n = 385). The investigation applied logistic regression to develop a risk prediction model utilizing clinical, pathological, and laboratory data. The efficacy of this model was then evaluated through receiver operating characteristic curve analysis. RESULTS In the present study, 11.28% of the participants (49 out of 434 participants) suffered from AL. Multivariate analysis revealed that preoperative levels of the OPNI, NLR, and PLR emerged as independent risk factors for AL, with odds ratios of 0.705 (95%CI: 0.641-0.775, P = 0.012), 1.628 (95%CI: 1.221-2.172, P =...