Background: In metabolic-bariatric fast-track surgery, patients are scheduled for discharge on postoperative day 1. The neutrophil-to-lymphocyte ratio (NLR) could be an inexpensive and rapid way to... Show moreBackground: In metabolic-bariatric fast-track surgery, patients are scheduled for discharge on postoperative day 1. The neutrophil-to-lymphocyte ratio (NLR) could be an inexpensive and rapid way to identify patients at risk of early complications. This study aimed to determine the predictive value of the NLR on early complications.Methods: Prospective data were collected of all patients undergoing primary metabolic surgery in a single center, between April 2018 and April 2019. The association between NLR, leukocyte count, hemoglobin, and C-reactive protein (CRP) was compared with early complications.Results: In total, 829 patients underwent primary metabolic surgery: 336 (40.5%) Roux-en-Y gastric bypass, 410 (49.5%) sleeve gastrectomy, and 83 (10.0%) one anastomosis gastric bypass. Major complications occurred in 34 (4.1%) patients, who had significantly higher levels of postoperative NLR (p < 0.001), delta-NLR (p < 0.001), leukocyte count (p < 0.001), and CRP (p = 0.008). The ideal cutoff points to predict complications after metabolic surgery were 6.73 for postoperative NLR (sensitivity 74% and specificity 70%) and 4.68 for delta-NLR (sensitivity 77% and specificity 75%).Conclusion: Postoperative NLR and delta-NLR were independently associated with early major complications after metabolic surgery. These markers may be useful to help identify patients who are at risk for complications, and can aid in the decision making for safe postoperative discharge on day 1 or early intervention. Show less
Marques, P.; Vries, F. de; Dekkers, O.M.; Korbonits, M.; Biermasz, N.R.; Pereira, A.M. 2021
Context: Serum inflammation-based scores reflect systemic inflammatory response and/or patients' nutritional status, and may predict clinical outcomes in cancer. While these are well-described and... Show moreContext: Serum inflammation-based scores reflect systemic inflammatory response and/or patients' nutritional status, and may predict clinical outcomes in cancer. While these are well-described and increasingly used in different cancers, their clinical usefulness in the management of patients with endocrine tumors is less known.Evidence acquisition: A comprehensive PubMed search was performed using the terms "endocrine tumor," "inflammation," "serum inflammation-based score," "inflammatory-based score," "inflammatory response-related scoring," "systemic inflammatory response markers," "neutrophil-to-lymphocyte ratio," "neutrophil-to-platelet ratio," "lymphocyte-to-monocyte ratio," "Glasgow prognostic score," "neutrophil-platelet score," "Systemic Immune-Inflammation Index," and "Prognostic Nutrition Index" in clinical studies.Evidence synthesis: The neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio are the ones most extensively investigated in patients with endocrine tumors. Other scores have also been considered in some studies. Several studies focused in finding whether serum inflammatory biomarkers may stratify the endocrine tumor patients' risk and detect those at risk for developing more aggressive and/or refractory disease, particularly after endocrine surgery.Conclusions: In this review, we summarize the current knowledge on the different serum inflammation-based scores and their usefulness in predicting the phenotype, clinical aggressiveness, and disease outcomes and prognosis in patients with endocrine tumors. The value of such serum inflammation-based scores in the management of patients with endocrine tumors has been emerging over the last decade. However, further research is necessary to establish useful markers and their cut-offs for routine clinical practice for individual diseases. Show less
