Prognostic Value of Systemic Inflammatory Response in Lymph Node-Negative Colorectal Cancer

Am Surg. 2024 Nov;90(11):3031-3037. doi: 10.1177/00031348241262430. Epub 2024 Jun 17.

Abstract

Background: The aim of this study was to investigate the prognostic value of systematic inflammatory response in patients with lymph node-negative colorectal cancer.

Methods: We retrospectively investigated 245 patients with lymph node-negative colorectal cancer who underwent curative resection and evaluated the prognostic impact of systematic inflammatory response, which was represented by neutrophil-to-lymphocyte ratio (NLR), prognostic nutritional index (PNI), and C-reactive protein-to-albumin ratio (CAR). Then, the prognostic significance of the systematic inflammatory response on survival was analyzed using the Kaplan-Meier method in patients selected by propensity score matching (PSM) analysis.

Results: In the multivariate analysis, CAR ≥ .081 (P = .004) was independent predictors of disease-free survival, while American Society of Anesthesiologists physical status ≥3 (P = .049) and CAR ≥ .081 (P < .001) were independent predictors of overall survival. By PSM analysis, PSM-high-CAR was significantly associated with worse disease-free survival (P = .043) and overall survival (P = .041) in patients with lymph node-negative colorectal cancer.

Conclusions: C-reactive protein-to-albumin ratio may be a significant indicator of poor long-term outcomes in patients with lymph node-negative colorectal cancer.

Keywords: colorectal cancer; inflammatory response; lymph node-negative.

MeSH terms

  • Aged
  • C-Reactive Protein* / analysis
  • C-Reactive Protein* / metabolism
  • Colorectal Neoplasms* / blood
  • Colorectal Neoplasms* / mortality
  • Colorectal Neoplasms* / pathology
  • Colorectal Neoplasms* / surgery
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lymph Nodes / pathology
  • Male
  • Middle Aged
  • Neutrophils
  • Nutrition Assessment
  • Prognosis
  • Propensity Score
  • Retrospective Studies
  • Serum Albumin / analysis
  • Serum Albumin / metabolism
  • Systemic Inflammatory Response Syndrome / blood
  • Systemic Inflammatory Response Syndrome / diagnosis
  • Systemic Inflammatory Response Syndrome / mortality

Substances

  • C-Reactive Protein
  • Serum Albumin