Systematic review articleThe impact of preoperative corticosteroids on the systemic inflammatory response and postoperative complications following surgery for gastrointestinal cancer: A systematic review and meta-analysis

â¿¢Systematic review and meta-analysis of preoperative corticosteroids in surgery for GI cancers.â¿¢Reports significant association between preoperative corticosteroids and lower postoperative IL-6 and CRP.â¿¢The relationship between corticosteroids and lower postoperative systemic inflammatory response may underpin the impact on postoperative complications.

BackgroundThis meta-analysis examined the impact of preoperative corticosteroids on interleukin 6 (IL-6), C-reactive protein (CRP), and complications following surgery for gastrointestinal cancer.MethodsA systematic review was performed using appropriate keywords. Random-effects meta-analysis was performed.Results11 RCTs with 474 patients, were included. Corticosteroids were significantly associated with lower IL-6 on postoperative day 1 (mean difference ⿿148 pg/mL, 95% CI ⿿205 to ⿿92, p < 0.001), 2 (⿿33 pg/mL, 95% CI ⿿58 to ⿿8, p = 0.01), and 3 (⿿31 pg/mL, 95% CI ⿿52 to ⿿11, p = 0.002), lower CRP on day 3 (⿿45 mg/L, 95% CI ⿿68 to ⿿21, p < 0.001), and 7 (⿿14 mg/L, 95% CI ⿿27 to ⿿1, p = 0.04), and fewer postoperative infective complications (OR 0.47, 95% CI 0.26⿿0.83, p = 0.01).ConclusionCorticosteroids were associated with reduction in the postoperative systemic inflammatory response and complications following surgery for gastrointestinal cancer.