Procalcitonin to Predict Infection After Gastrectomy for Gastric Cancer

Overview

To investigate the diagnostic accuracy of procalcitonin as an early predictor of infection after radical gastrectomy for gastric cancer.

Full Title of Study: “Diagnostic Accuracy of Procalcitonin as an Early Predictor of Infection After Radical Gastrectomy for Gastric Cancer: a Prospective Bi-center Study”

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: July 28, 2019

Detailed Description

From June 2018 to May 2019, consecutive eligible patients who underwent surgery for gastric cancer in the Department of Gastroduodenal and Pancreatic Surgery, Hunan Cancer Hospital and the treatment group of Professor Kai-xiong Tao in the Union Hospital of Tongji Medical College were invited to participate in the study. After surgery, routine blood test were measured morning on post-operative day (POD) 1, 3, 5, and 7, and serum level of procalcitonin was measured morning on POD 3 and 5.

The primary outcome of the present study was the accuracy of white blood cell (WBC) and neutrophil count, the neutrophil to WBC ratio (N%) and procalcitonin to detect post-operative infection (including intra-abdominal infection (IAI), surgical site infections (SSIs), pneumonia, urinary tract infection, catheter-related infection, and sepsis not specified) within 30 days after surgery. The main secondary outcome was their ability to detect any post-operative complications (such as intestinal obstruction, bleeding, ascites, cardiovascular and cerebrovascular events) within 30 days after surgery. Other secondary outcomes were the choice of the best timing to measure each inflammatory marker, the choice of a clinically meaningful cut-off value for the most accurate marker.

Arms, Groups and Cohorts

  • infection group and non-infection group
    • patients were divided into 2 sub-groups according to the presence of infection or not after radical gastrectomy for gastric cancer.

Clinical Trial Outcome Measures

Primary Measures

  • diagnostic accuracy of procalcitonin to detect post-operative infection
    • Time Frame: within 30 days after surgery
    • the accuracy of procalcitonin to detect post-operative infection

Secondary Measures

  • diagnostic accuracy of procalcitonin to detect overall post-operative complications
    • Time Frame: within 30 days after surgery
    • the accuracy of procalcitonin to detect any post-operative complications

Participating in This Clinical Trial

Inclusion Criteria

1. ≥ 18 years

2. pathologically diagnosed gastric adenocarcinoma

3. radical gastrectomy with lymphadenectomy.

Exclusion Criteria

1. ongoing infection at surgery

2. pregnancy status

3. underwent non-resection surgery

4. underwent palliative gastrectomy

5. emergency surgery

6. taking corticosteroid or other immunosuppressive drugs

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Yongchang Zhang
  • Collaborator
    • Huazhong University of Science and Technology
  • Provider of Information About this Clinical Study
    • Sponsor-Investigator: Yongchang Zhang, Hunan Province Tumor Hospital – Hunan Province Tumor Hospital
  • Overall Official(s)
    • Hua Xiao, Principal Investigator, Hunan Cancer Hospital

Citations Reporting on Results

Facy O, Paquette B, Orry D, Binquet C, Masson D, Bouvier A, Fournel I, Charles PE, Rat P, Ortega-Deballon P; IMACORS Study. Diagnostic Accuracy of Inflammatory Markers As Early Predictors of Infection After Elective Colorectal Surgery: Results From the IMACORS Study. Ann Surg. 2016 May;263(5):961-6. doi: 10.1097/SLA.0000000000001303.

Cousin F, Ortega-Deballon P, Bourredjem A, Doussot A, Giaccaglia V, Fournel I. Diagnostic Accuracy of Procalcitonin and C-reactive Protein for the Early Diagnosis of Intra-abdominal Infection After Elective Colorectal Surgery: A Meta-analysis. Ann Surg. 2016 Aug;264(2):252-6. doi: 10.1097/SLA.0000000000001545.

Xiao H, Quan H, Pan S, Yin B, Luo W, Huang G, Ouyang Y. Impact of peri-operative blood transfusion on post-operative infections after radical gastrectomy for gastric cancer: a propensity score matching analysis focusing on the timing, amount of transfusion and role of leukocyte depletion. J Cancer Res Clin Oncol. 2018 Jun;144(6):1143-1154. doi: 10.1007/s00432-018-2630-8. Epub 2018 Mar 23.

Muñoz JL, Ruiz-Tovar J, Miranda E, Berrio DL, Moya P, Gutiérrez M, Flores R, Picó C, Pérez A. C-Reactive Protein and Procalcitonin as Early Markers of Septic Complications after Laparoscopic Sleeve Gastrectomy in Morbidly Obese Patients Within an Enhanced Recovery After Surgery Program. J Am Coll Surg. 2016 May;222(5):831-7. doi: 10.1016/j.jamcollsurg.2016.01.059. Epub 2016 Feb 13.

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