Nomograms for predicting prognostic value of inflammatory biomarkers in colorectal cancer patients after radical resection

Abstract

Increasing evidence indicates that inflammation plays a vital role in tumorigenesis and progression. However, the prognostic value of inflammatory biomarkers in colorectal cancer (CRC) has not been established. In this study, a retrospective analysis was conducted in patients with CRC in Fudan University Shanghai Cancer Center (FUSCC) between April 1, 2007 and April 30, 2014, and 5,336 patients were identified eligible. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and albumin/globulin ratio (AGR) were analyzed. Kaplan-Meier analysis was used to calculate the 5-year overall survival (OS) and disease-free survival (DFS). Cox regression analysis was performed to assess the prognostic factors. Nomograms were established to predict OS and DFS, and Harrell's concordance index (c-index) was adopted to evaluate prediction accuracy. As results, the 5-year OS was 79.2% and the 5-year DFS was 56.0% in the cohort. Patients were stratified into 2 groups by NLR (2.72 and >2.72), PLR (219.00 and >219.00), LMR (2.83 and >2.83) and AGR (<1.50 and 1.50). Patients with NLR > 2.72, PLR > 219.00, LMR 2.83 and AGR < 1.50 were significantly associated with decreased OS and DFS (p < 0.001). Multivariate analysis indicated that NLR, LMR and AGR were independent factors of OS (p 5 0.047, p 5 0.008 and p < 0.001, respectively) and DFS (p 5 0.009, p < 0.001 and p 5 0.008, respectively). In addition, nomograms on OS and DFS were established according to all significant factors, and c-indexes were 0.765 (95% CI: 0.744-0.785) and 0.735 (95% CI: 0.721-0.749), respectively. Nomograms based on OS and DFS can be recommended as practical models to evaluate prognosis for CRC patients.Colorectal cancer (CRC) is the third most commonly diagnosed cancer in males and the second in females.1 The estimated global 5-year prevalence rate of CRC was 68.2/100,000, and cancer death rate caused by CRC was about 8.5%. 2 Compared with developed countries, the 5-year prevalence rate of CRC is significantly lower in China (52.7/100,000), but the mortality-to-prevalence ratio (MPR) of CRC in China (14%) is a lot higher, 2 which indicates that the overall survival outcome of CRC is apparently worse in China. Surgical resection remains the only curative treatment option for colorectal cancer. However, a considerable proportion of CRC patients develop recurrence or metastasis within 5 years after surgical treatment. Thus, a better model to predict the prognosis of CRC patients after radical resection is urgently needed.

Prognostic value of the lymphocyte monocyte ratio in patients with colorectal cancer

“…As a result, a total of nine studies comprising 8626 patients with CRC fulfilled all of the inclusion criteria. [9,10,15–21] The PRISMA flow diagram of the study selection process was shown in Fig. 1.…”

Nomogram based on albumin and neutrophil-to-lymphocyte ratio for predicting the prognosis of patients with oral cavity squamous cell carcinoma

“…When reviewing the literature, there are different cut-off values for biomarkers, ratios and scores based on cancer type and study population/area. Thus, it is difficult to create standardized cut-offs that can be used worldwide, even within a single cancer type 19,48,49 . Second, this dataset included only patients who underwent surgical resection for OSCC.…”

A Nomogram based on Inflammatory Factors C-Reactive Protein and Fibrinogen to Predict the Prognostic Value in Patients with Resected Non-Small Cell Lung Cancer

“…In recent years, nomograms have been constructed in a variety of cancers, and some of them have been found to be more reliable prediction than the traditional staging system 23, 32-34. Moreover it has been validated to compare favorably to the traditional TNM staging systems in many cancers, and thus have been identified as an alternative or even a new standard 22, 35, 36. A number of studies also found that in patients with NSCLC, nomograms were accurate to predict the risk of a node's involvement 37, 38, the individual risk of developing metastasis to the brain and had strong performance in individualize patient decision making 39.…”