Pretreatment inflammatory markers predicting treatment outcomes in colorectal cancer

Abstract

We aimed to review whether pretreatment inflammatory markers reflect the short- and long-term outcomes of patients with colon cancer, rectal cancer, colon and rectal cancers, and metastatic colorectal cancer (CRC). We found that pretreatment complete blood count and blood chemistry tests reflect short-term and long-term oncological outcomes in patients with CRC. Specifically, in patients with colon cancer, hypoalbuminemia was associated with worse postoperative morbidity, mortality, and inferior survival. In patients with rectal cancer, elevated neutrophil-lymphocyte ratio (NLR) and thrombocytosis were associated with postoperative complications, poor overall survival (OS), and disease-free survival (DFS). A high C-reactive protein/albumin ratio (CAR) was associated with poor OS and DFS. In patients with metastatic CRC, increased NLR and platelet-lymphocyte ratio (PLR) were associated with poor OS, DFS, and progression-free survival (PFS). In addition, high CAR and a low albumin/globulin ratio on blood chemistry tests were associated with poor OS and PFS. Although universal cut-off values were not available, various types of pretreatment laboratory markers could be utilized as adjuncts to predict prognosis in patients with CRC.

Combining prognostic nutritional index (PNI) and controlling nutritional status (CONUT) score as a valuable prognostic factor for overall survival in patients with stage I–III colorectal cancer

“…The multivariable analysis showed that prognostic nutritional index was an independent prognostic factor for overall survival, whereas the controlling nutritional status score, neutrophil-to-lymphocyte ratio, lymphocyte-tomonocyte ratio, and platelet-to-lymphocyte ratio were not. The patients were divided into three P-CONUT groups as follows: G1, controlling nutritional status (0-4) and high prognostic nutritional index; G2, controlling nutritional status (0-4) and low prognostic nutritional index; and G3, controlling nutritional status (5)(6)(7)(8)(9)(10)(11)(12) and low prognostic nutritional index. There were significant survival differences between the P-CONUT groups (5-year overall survival of G1, G2, and G3 were 91.7%, 81.2%, and 64.1%, respectively; p < 0.0001).…”

“…The CONUT score was calculated using serum albumin (g/dL), total lymphocyte (count/mm 3 ), and total cholesterol (mg/dL) levels (Supplementary Table S1). In our study, the patients were divided into low (0-1), intermediate (2)(3)(4), and high (5)(6)(7)(8)(9)(10)(11)(12) CONUT score groups as previously described (5). PNI was calculated as 10 × serum albumin (g/dL) + 0.005 × total peripheral lymphocyte count (mL).…”

“…Nutritional markers are regarded as important pre-surgical prognostic factors because malnutrition is associated with wound healing delay, muscle weakness, immune dysfunction, infection, and further postoperative complications, leading to increased mortality ( 7 , 8 ). Inflammation is also correlated with cancer progression, and several studies have identified the molecular pathways of cancer-related inflammation ( 9 , 10 ).…”

“…Methods: We retrospectively evaluated 1112 patients with stage I-III colorectal cancer between January 2004 and April 2014. The controlling nutritional status scores were classified as low (0-1), intermediate (2)(3)(4), and high (5)(6)(7)(8)(9)(10)(11)(12) scores. The cut-off values for prognostic nutritional index and inflammatory markers were calculated using the X-tile program.…”

A Novel Prognostic Index for Metastatic Colon Cancer: The Prognostic Immune Nutritional Index

“…It was also determined to be an independent prognostic factor for mCC patients [25]. In multiple studies, hypoalbuminemia was associated with poor OS in mCC and poor disease-free survival in colon cancer patients undergoing surgery [26][27][28]. In multiple studies, the monocyte count in different prognostic markers was associated with OS in mCC patients [29,30].…”