The early diagnostic value of C-reactive protein for anastomotic leakage post radical gastrectomy for esophagogastric junction carcinoma: A retrospective study of 97 patients

• Surgical esophagogastric junction carcinoma (EJC) patients have high rates of complications including anastomotic leakage.
• EJC patients with anastomotic leakage showed early elevated serum C-reactive protein (CRP) levels at Day 2 after operations.
• EJC patients with higher levels of serum CRP post-surgery should be examined for the existence of anastomotic leakage.

Background/AimsThe incidence of esophagogastric junction (EGJ) carcinoma has increased worldwide. The only curable strategy for EGJ carcinoma is surgery, whereas anastomotic leakage is the major complication after operations. We aimed to test whether the serum levels of C-reactive protein have the diagnostic value for anastomotic leakage after surgery for EGJ carcinoma.MethodsIn this study, we analyzed the values of CRP before and 5 continuous days after surgery in 97 EGJ carcinoma patients who received surgery as the initial treatment. The levels of CRP in the groups of EGJ patients with or without anastomotic leakage were compared.ResultsThe CRP levels of patients with anastomotic leakage elevated faster and remained higher compared patients without anastomotic leakage. The CRP value at Day 2 after radical surgery for EGJ carcinoma patients has the early diagnostic value for anastomotic leakage. The cut-off value of CRP for anastomotic leakage at Day 2 is 177 mg/l with the sensitivity of 0.9 and specificity of 0.95 (P < 0.0001).ConclusionSurgical EGJ carcinoma patients with elevated CRP at Day 2 after surgery should be excluded the possibility of anastomotic leakage.