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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Surgical Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1416888

The Clinical Outcome of Minor Changes in Serum Creatinine for Patients After Curative Gastrectomy: A Prospective Study

Provisionally accepted
Wen-Tao Cai Wen-Tao Cai 1Xiu-Ya Zeng Xiu-Ya Zeng 1*Yun-Shi Huang Yun-Shi Huang 1Wei-Sheng Chen Wei-Sheng Chen 2*Xiangjian Chen Xiangjian Chen 1*Xian-Hai Xie Xian-Hai Xie 1*
  • 1 First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
  • 2 Department of Gastrointestinal Surgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China

The final, formatted version of the article will be published soon.

    Introduction: Patients with renal insufficiency are more prone to postoperative complications (PCs). Studies have shown that minor changes in serum creatinine (SCr), immediately post-surgery, can aid in assessing patients' renal function. This study aimed to explore the relationship between the changes in SCr and PCs in patients with gastric cancer (GC).We prospectively collected data regarding the SCr of 530 GC patients, within 2 weeks before surgery and within 24 hours after surgery in our hospital (2014)(2015)(2016). The patients were divided into three groups according to the level of SCr change after surgery: reduced (<10%), normal (10%), and elevated (>10%) creatinine groups. Univariate and multivariate logistic analysis were performed to evaluate its correlation with short-term PCs in the patients. The R language was used to construct a nomogram.Results: Eighty-three, 217, and 230 patients were assigned to the elevated, reduced, and normal SCr groups, respectively. Multivariate analysis showed that the reduced and elevated SCr groups were independently associated with the occurrence of PCs and severe postoperative complications (SPCs), respectively. Additionally, postsurgical SCr change, age, hypoalbuminemia, total gastrectomy, combined resection, and laparoscopy, were independently related to PCs. Combining the above influential factors, the predictive model can distinguish patients with PCs more reliably (c-index is 0.715).Post-surgery, reduced SCr is a protective factor for PCs, while elevated serum creatinine is an independent risk factor for SPCs. Our nomogram can identify GC patients with high risks of PCs.

    Keywords: gastric cancer, serum creatinine changes, postoperative outcomes, nomogram, prospective study

    Received: 25 Apr 2024; Accepted: 29 Jul 2024.

    Copyright: © 2024 Cai, Zeng, Huang, Chen, Chen and Xie. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Xiu-Ya Zeng, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
    Wei-Sheng Chen, Department of Gastrointestinal Surgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
    Xiangjian Chen, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
    Xian-Hai Xie, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.