title: The impact of preoperative corticosteroids on the systemic inflammatory response and postoperative complications following surgery for gastrointestinal cancer: A systematic review and meta-analysis.
abstract: BACKGROUND
  This meta-analysis examined the impact of preoperative corticosteroids on interleukin 6 (IL-6), C-reactive protein (CRP), and complications following surgery for gastrointestinal cancer.
  
  
  METHODS
  A systematic review was performed using appropriate keywords. Random-effects meta-analysis was performed.
  
  
  RESULTS
  11 RCTs with 474 patients, were included. Corticosteroids were significantly associated with lower IL-6 on postoperative day 1 (mean difference -148pg/mL, 95% CI -205 to -92, p<0.001), 2 (-33pg/mL, 95% CI -58 to -8, p=0.01), and 3 (-31pg/mL, 95% CI -52 to -11, p=0.002), lower CRP on day 3 (-45mg/L, 95% CI -68 to -21, p<0.001), and 7 (-14mg/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).
  
  
  CONCLUSIONS
  Corticosteroids were associated with reduction in the postoperative systemic inflammatory response and complications following surgery for gastrointestinal cancer.
authors.affiliation: Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow, UK. Electronic address: s.mcsorley@doctors.org.uk.
authors.forename: Stephen T
authors.initials: ST
authors.lastname: McSorley
authors.affiliation: Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow, UK.
authors.forename: Paul G
authors.initials: PG
authors.lastname: Horgan
authors.affiliation: Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow, UK.
authors.forename: Donald C
authors.initials: DC
authors.lastname: McMillan
mesh_terms: D000305:Adrenal Cortex Hormones / Q000097:blood*; D000818:Animals; D002097:C-Reactive Protein / Q000032:analysis; D005770:Gastrointestinal Neoplasms / Q000097:blood* / Q000601:surgery; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D011183:Postoperative Complications / Q000097:blood*
chemical_list: D000305:Adrenal Cortex Hormones; C508600:IL6 protein, human; D015850:Interleukin-6; D002097:C-Reactive Protein
keywords: Corticosteroids; Gastrointestinal cancer; Morbidity; Postoperative complications; Stress response