Clinical Report: Preoperative Biomarkers and Postoperative Pulmonary Complications

Overview

This systematic review evaluates the association between preoperative inflammatory and immune-nutritional biomarkers and postoperative pulmonary complications (PPCs) in gastrointestinal cancer surgery.

Background

Postoperative pulmonary complications are a significant source of morbidity following gastrointestinal cancer surgery. Identifying reliable preoperative markers could enhance risk stratification and improve patient outcomes. This study systematically reviews existing literature to clarify the relationship between these biomarkers and PPCs.

Data Highlights

No formal pooled meta-analysis was performed due to heterogeneity in definitions and methodologies across studies.

Key Findings

• Fifteen observational studies were included, showing moderate-to-high methodological quality.
• Adverse preoperative inflammatory profiles were associated with increased PPC risk.
• Inflammatory markers such as neutrophil-to-lymphocyte ratio and systemic immune-inflammation index showed strong associations with PPCs.
• Nutritional indicators like albumin and prognostic nutritional index indicated elevated risk in patients with poor nutritional status.
• Combined inflammatory burden and nutritional impairment were recurrent patterns observed across studies.
• Standardized prospective studies are needed for reliable integration of these markers into clinical practice.

Clinical Implications

Healthcare professionals should consider the combined assessment of inflammatory and nutritional markers preoperatively to better stratify patients at risk for PPCs. This approach may inform perioperative management strategies.

Conclusion

Current evidence suggests a preoperative double burden of heightened systemic inflammation and impaired nutritional status is associated with increased postoperative pulmonary risk after gastric and colorectal cancer surgery.

Related Resources & Content

1. Frontiers in Medicine, 2026 -- Preoperative neutrophil-to-lymphocyte ratio and systemic immune-inflammation index as prognostic biomarkers for postoperative pneumonia and pulmonary complications after thoracic surgery: a systematic review and meta-analysis
2. Techniques in Coloproctology, 2025 -- Employing Inflammatory Markers to Facilitate Safe and Timely Discharge Following Minimally Invasive Colorectal Surgery for Colorectal Cancer
3. Evaluating Nutritional Status through Subjective Global Assessment and Its Influence on Surgical Results: A Prospective Investigation in Elderly Colorectal Cancer Patients
4. Preoperative Inflammatory Biomarkers and Their Impact on Outcomes in Liver Resection for Colorectal Liver Metastases: Insights from a National Registry Analysis
5. Evaluation and Management of Perioperative Pulmonary Complications - PubMed
6. ESPEN guideline on clinical nutrition in surgery – Update 2025 - Clinical Nutrition
7. Development and validation of a risk prediction model related to inflammatory and nutritional indexes for postoperative pulmonary infection after radical colorectal cancer surgery - PubMed
8. Evaluation and Management of Perioperative Pulmonary Complications - PubMed
9. ESPEN guideline on clinical nutrition in surgery – Update 2025 - Clinical Nutrition
10. Development and validation of a risk prediction model related to inflammatory and nutritional indexes for postoperative pulmonary infection after radical colorectal cancer surgery - PubMed