Biomarker-Guided Inflammatory Control and Multidimensional Recovery After Abdominoperineal Resection: A Prospective Cohort Study
Abstract
BACKGROUND
Patients undergoing abdominoperineal resection (APR) for rectal cancer frequently experience persistent inflammation, nutritional decline, and psychosocial distress, which may adversely affect postoperative recovery and longer-term clinical trajectories.
METHODS
In this single-center, prospective nonrandomized cohort, 200 patients with stage I-III rectal adenocarcinoma undergoing APR received either standard Enhanced Recovery After Surgery (ERAS) care (n = 100) or a biomarker-guided program (n = 100) integrating inflammatory modulation and immunometabolic/nutritional support. Supplements (sodium butyrate, multi-strain probiotics, omega-3 fatty acids) were Good Manufacturing Practice-certified and titrated to predefined C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) thresholds. The prespecified primary endpoint was change in Beck Depression Inventory-II (BDI-II) score over 24 months, selected to reflect patient-centered psychosocial recovery after APR. Secondary endpoints included sleep (Pittsburgh Sleep Quality Index, PSQI), sexual function (IIEF-5/FSFI), QLQ-C30 role/emotional functioning, inflammatory and immune markers, skeletal muscle index, and exploratory disease-free survival (DFS) and overall survival (OS). The present report should be interpreted as an interim medium-term analysis rather than a definitive long-term oncologic evaluation. The study was approved by the institutional ethics committee, and the protocol…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 200 participants or records.
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