Background: To explore the prognostic value of the preoperative neutrophil-albumin ratio (NAR) in patients with colorectal cancer (CRC) undergoing surgical treatment.Materials and methods: The standardized log-rank statistic was used to determine the optimal cut-off value for NAR. A logistic regression model was used to evaluate the value of NAR in predicting postoperative complications. Cox proportional hazards models were used to assess the independent association of NAR with progression-free survival (PFS) and overall survival (OS) in CRC patients. Restricted cubic splines were used to assess the relationship between continuous NAR and survival in CRC patients. The Kaplan–Meier method and log-rank test were used to compare survival differences between low and high NAR groups. NAR-based prognostic nomograms were constructed to predict the 1–5-year PFS and OS of CRC patients. The concordance index (C-index) and calibration curve were used to evaluate the prognostic accuracy of the nomograms.Results: A total of 1,441 CRC patients were enrolled from January 2012 to December 2016. There were 904 men (62.7%) and 537 women (37.3%), with an average age of 58.12 ± 13.15 years. High NAR was closely associated with low BMI, advanced pathological stage, colon cancer, large tumors, vascular invasion, poor differentiation, high CEA levels, long hospital stay, and recurrence and metastasis. A high NAR was an independent risk factor for postoperative complications in CRC patients (OR: 2.298, 95% CI: 1.642–3.216, p < 0.001). Patients with a high NAR had worse PFS (40.7 vs. 59.5%, p < 0.001) and OS (42.6 vs. 62.4%, p < 0.001). After adjusting for confounders, high NAR was independently associated with PFS (HR: 1.280, 95% CI: 1.031–1.589, p = 0.025) and OS (HR: 1.280; 95% CI: 1.026–1.596, p = 0.029) in CRC patients. The C-index and calibration curves showed that the NAR-based prognostic nomograms had good predictive accuracy.Conclusion: High NAR was an independent risk factor for postoperative complications and long-term prognosis of CRC patients. NAR-based research could provide references for prognostic judgment and clinical decision-making of CRC patients.

Background: To explore the value of preoperative prognostic immune and nutritional index (PINI) in predicting postoperative complications and long-term outcomes in patients with stage I–III colorectal cancer (CRC). Methods: Restricted cubic splines were used to assess the relationship between PINI and survival in patients with CRC. The Kaplan–Meier method and log-rank test were used to plot the survival curves. The Cox proportional hazards model was used to evaluate independent prognostic predictors in patients with CRC. A logistic regression analysis was performed to identify independent predictors of postoperative complications. The least absolute shrinkage and selection operator (LASSO) logistic regression algorithm was used for feature screening. Results: An evident positive dose–response relationship between PINI and survival in patients with CRC was identified. Compared with patients with a high PINI, those with a low PINI had worse disease-free survival (DFS) (47.9% vs. 66.9%, p < 0.001) and overall survival (OS) (49.7% vs. 70.2%, p < 0.001). The Cox proportional hazards model revealed that PINI was independently associated with DFS (hazard ratio [HR], 0.823; 95% confidence interval [CI], 0.754–0.898; p < 0.001) and OS (HR, 0.833; 95% CI, 0.761–0.912; p < 0.001) in patients with CRC. In the logistic regression analysis, PINI was an independent factor affecting postoperative complications in patients with CRC (odds ratio, 0.710; 95%CI: 0.610–0.810, p < 0.001). The LASSO logistic regression algorithm was used to screen for effective prognostic variables. Finally, we constructed PINI-based nomograms to predict postoperative 1–5-year PFS, and OS in patients with CRC. Conclusion: PINI is an effective biomarker for predicting postoperative complications, DFS, and OS in patients with stage I–III CRC.

Background: This study aimed to explore the relationship between creatinine/cystatin C ratio and progression-free survival (PFS) and overall survival (OS) in colorectal cancer (CRC) patients undergoing surgical treatment.Methods: A retrospective analysis was conducted on 975 CRC patients who underwent surgical resection from January 2012 to 2015. Restricted three-sample curve to display the non-linear relationship between PFS/OS and creatinine-cystatin C ratio. Cox regression model and Kaplan-Meier method were used to evaluate the effect of the creatinine-cystatin C ratio on the survival of CRC patients. Prognostic variables with p-value ≤0.05 in multivariate analysis were used to construct prognostic nomograms. The receiver operator characteristic curve was used to compare the efficacy of prognostic nomograms and the traditional pathological stage.Results: There was a negative linear relationship between creatinine/cystatin C ratio and adverse PFS in CRC patients. Patients with low creatinine/cystatin C ratio had significantly lower PFS/OS than those with high creatinine/cystatin C ratio (PFS, 50.8% vs. 63.9%, p = 0.002; OS, 52.5% vs. 68.9%, p < 0.001). Multivariate analysis showed that low creatinine/cystatin C ratio was an independent risk factor for PFS (HR=1.286, 95%CI = 1.007–1.642, p=0.044) and OS (HR=1.410, 95%CI=1.087–1.829, p=0.010) of CRC patients. The creatinine/cystatin C ratio-based prognostic nomograms have good predictive performance, with a concordance index above 0.7, which can predict the 1–5-year prognosis.Conclusion: Creatinine/cystatin C ratio may be an effective prognostic marker for predicting PFS and OS in CRC patients, aid in pathological staging, and along with tumour markers help in-depth prognostic stratification in CRC patients.

BACKGROUND:According to the latest statistics from the American Cancer Society, there will be 1.73 million cancer cases and more than 600 000 cancer deaths in the United States in 2018, among which there will be 26 240 new cases of gastric cancer and...

Background: The neutrophil percentage-to-albumin ratio (NPAR) is a promising indicator for predicting outcomes in various cancers. However, its prognostic value in colorectal cancer (CRC) is still underexplored. This study aimed to investigate the relationship between NPAR and progression-free survival (PFS) as well as overall survival (OS) in CRC patients.Methods: We conducted a retrospective cohort study involving 1,339 CRC patients who underwent surgical resection. The Kaplan-Meier method was utilized to plot survival curves for PFS and OS. Cox proportional hazards regression analysis assessed the relationship between NPAR and survival outcomes. The nomograms that included NPAR and other significant prognostic factors were developed to predict 1-, 3-, and 5-year survival rates.Results: Patients with high NPAR (≥1.62) experienced significantly worse PFS and OS compared to those with low NPAR (<1.62) (PFS: 47.4% vs. 63.1%, p < 0.001; OS: 50.1% vs. 65.9%, p < 0.001). Compared to other relevant markers, NPAR exhibited strong prognostic predictive efficacy. Multivariate Cox regression analysis identified high NPAR as an independent predictor of poor PFS (hazard ratio [HR] = 1.671, 95% Confidence Interval [CI]: 1.142–2.444, p = 0.008) and OS (HR = 2.697, 95% CI: 1.761–4.130, p < 0.001). The NPAR-based nomograms demonstrated high predictive accuracy and received favorable evaluations in the internal validation cohort.Conclusion: Preoperative NPAR is a promising indicator for predicting PFS and OS in CRC patients. The NPAR-based nomogram offers a practical tool for personalized survival prediction and may assist in clinical decision-making.