The advanced lung cancer inflammation index is a novel independent prognosticator in colorectal cancer patients after curative resection

Abstract

Background:The advanced lung cancer inflammation index (ALI), which comprehensively evaluates the patient body composition and inflammation/nutritional status, is reportedly associated with the patient outcome in lung cancer. However, the clinical significance in colorectal cancer (CRC) patients after curative resection remains unclear. Methods: A total of 813 CRC patients after curative resection between April 2005 and June 2019 in a single institution were retrospectively enrolled. The association of the preoperative ALI (calculated as follows: body mass index × albumin value/ neutrophil-to-lymphocyte ratio) with clinicopathological factors, postoperative complications, and survival was analyzed.Results: A low ALI was significantly associated with male gender, older age, a higher depth of tumor invasion, progressed TNM stage, and preoperative carcinoembryonic antigen (CEA) positivity. Both postoperative complications and severe complications occurred more frequently in the ALI-low group than in the ALI-high group (P < .001 and P < .001, respectively), especially postoperative complications in stage III patients (P < .001) and severe complications in stages II and III patients (P = .024 and P = .004, respectively). In addition, a low ALI was an independent predictor of a poor overall survival (hazard ratio: 2.30, 95% confidence interval: 1.52-3.50, P < .001) and relapse-free survival (hazard ratio: 1.73, 95% confidence interval: 1.22-2.44, P = .002), especially in older patients, and in patients without lymph node metastasis or severe postoperative complications. Conclusion:This study suggests that preoperative ALI may serve as a novel independent predictive index for severe postoperative complications and recurrence in CRC patients after curative resection.

Advanced lung cancer inflammation index (ALI) predicts prognosis of patients with gastric cancer after surgical resection

“…ALI may have superior prognostic value as it reflects a combination of inflammation and nutrition status. Consistently, ALI as an independent predictor of many tumors, such as colon cancer [ 10 , 11 ] and non-small cell lung cancer [ 12 , 13 ], has been gradually revealed. However, there are few studies on the clinical significance of ALI in GC patient.…”

The advanced lung cancer inflammation index is a prognostic factor for gastrointestinal cancer patients undergoing surgery: a systematic review and meta-analysis

“…Pian G, Yin CZ, and Barth DA et al demonstrated that there was no significant difference in ALI between patients receiving CRC surgery or GC surgery [ 22 , 28 , 34 ]. Others thought that a low ALI level would lead to a poor prognosis for gastrointestinal cancer patients [ 21 , 23 – 27 , 29 – 33 ]. Therefore, we aimed to explore the exact prognostic ability of ALI for patients with gastrointestinal cancer undergoing surgery.…”

“…Therefore, ALI could reflect the inflammation and nutrition state. Currently, some studies have reported that ALI can predict the survival of many cancers, including CRC [21][22][23][24][25][26][27], GC [28,29], EC [30,31], liver cancer [32], cholangiocarcinoma [33], pancreatic cancer [34,35], and B-cell lymphoma [36].…”

Preoperative Cancer Inflammation Prognostic Index as a Superior Predictor of Short- and Long-Term Outcomes in Patients with Stage I–III Colorectal Cancer after Curative Surgery

“…A new prognostic index, defined as the cancer-inflammation prognostic index (CIPI), based on CEA and NLR, was recently introduced as a promising novel prognostic marker for metastatic CRC patients treated with regorafenib [ 26 , 27 ]. To our knowledge, CIPI has never been utilized as a prognostic marker in non-metastatic CRC after curative resection.…”