Next Article in Journal
Seizures Do Not Affect Disability and Mortality Outcomes of Stroke: A Population-Based Study
Previous Article in Journal
High Prevalence of Antibiotic Resistance in Iranian Helicobacter pylori Isolates: Importance of Functional and Mutational Analysis of Resistance Genes and Virulence Genotyping
Previous Article in Special Issue
Is There Any Role for Super-Extended Limphadenectomy in Advanced Gastric Cancer? Results of an Observational Study from a Western High Volume Center
Open AccessReview

Systematic Review of the Role of Biomarkers in Predicting Anastomotic Leakage Following Gastroesophageal Cancer Surgery

1
Department of Surgery, Zuyderland Medical Center, 6126BG Sittard-Geleen, The Netherlands
2
Department of Epidemiology, Zuyderland Medical Center, 6126BG Sittard-Geleen, The Netherlands
*
Author to whom correspondence should be addressed.
These authors contribute equally to this work.
J. Clin. Med. 2019, 8(11), 2005; https://doi.org/10.3390/jcm8112005
Received: 19 September 2019 / Revised: 11 November 2019 / Accepted: 14 November 2019 / Published: 17 November 2019
(This article belongs to the Special Issue Surgical Management of Gastric Cancer)
Anastomotic leakage (AL) following gastroesophageal cancer surgery remains a serious postoperative complication. This systematic review aims to provide an overview of investigated biomarkers for the early detection of AL following esophagectomy, esophagogastrectomy and gastrectomy. All published studies evaluating the diagnostic accuracy of biomarkers predicting AL following gastroesophageal resection for cancer were included. The Embase, Medline, Cochrane Library, PubMed and Web of Science databases were searched. Risk of bias and applicability were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) 2 tool. Twenty-four studies evaluated biomarkers in the context of AL following gastroesophageal cancer surgery. Biomarkers were derived from the systemic circulation, mediastinal and peritoneal drains, urine and mediastinal microdialysis. The most commonly evaluated serum biomarkers were C-reactive protein and leucocytes. Both proved to be useful markers for excluding AL owing to its high specificity and negative predictive values. Amylase was the most commonly evaluated peritoneal drain biomarker and significantly elevated levels can predict AL in the early postoperative period. The associated area under the receiver operating characteristic (AUROC) curve values ranged from 0.482 to 0.994. Current biomarkers are poor predictors of AL after gastroesophageal cancer surgery owing to insufficient sensitivity and positive predictive value. Further research is needed to identify better diagnostic tools to predict AL. View Full-Text
Keywords: anastomotic leakage; upper gastrointestinal tract; biomarkers anastomotic leakage; upper gastrointestinal tract; biomarkers
Show Figures

Figure 1

MDPI and ACS Style

de Mooij, C.M.; Maassen van den Brink, M.; Merry, A.; Tweed, T.; Stoot, J. Systematic Review of the Role of Biomarkers in Predicting Anastomotic Leakage Following Gastroesophageal Cancer Surgery. J. Clin. Med. 2019, 8, 2005.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop