Preoperative TNF-α predicts uneventful postoperative outcomes in patients undergoing colorectal cancer surgery

The development of novel biomarkers to predict postoperative complications (POCs) after colorectal cancer (CRC) surgery is essential, both for improving treatment outcomes and for facilitating the widespread use of same-day discharge following colectomy. This longitudinal observational study, a sub-study of a previous RCT, investigated the prognostic potential of a panel of novel biomarkers, including inflammatory cytokines (TNF-α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-17 A, INF-γ, IP-10, MCP-1, TGF-β1), alongside conventional biomarkers such as CRP and WBC levels, measured preoperatively and on postoperative day 6, for predicting POCs following CRC resection. Among 40 recruited patients, 38 were included in the final analysis. Patients who did not experience POCs had a significantly lower preoperative level of TNF-α (2.28 pg/mL vs. 68.77 pg/mL, p = 0.022). ROC curve analysis showed that TNF-α has significant (p = 0.012) discriminative capacity to distinguish between patients with POCs and those with an uneventful postoperative course, with an AUC of 0.722 (95% CI: 0.555, 0.889). Multivariable analysis suggested that a low preoperative TNF-α level (< 55.35 pg/mL) may be an independent predictor of an uneventful postoperative course (Odds Ratio = 0.137, 95% CI: 0.023, 0.836). This study showed that preoperative levels of TNF-α demonstrates a moderate discriminative capacity to distinguish between patients with POCs and those with an uneventful postoperative course in patients undergoing surgery for left-side CRC, although the findings are limited by the small sample size and should be validated in larger cohorts.Clinical Trial Registration: NCT04013841, date of registration 2019-07-10.