Purpose: To explore the role of preoperative inflammatory markers (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocytes level) combined with tumor stage in the prognostic evaluation of colorectal cancer (CRC).
Methods: A total of 70 CRC patients who were operated on between June 2016 and February 2019 were included in this study. A prognostic nomogram was established based on the integration of tumor stage prognostic factors with neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte level, and compared with a nomogram based only on the prognostic factors of tumor stage. Survival risk and prediction accuracy were assessed by using the Harrell's concordance index (c-index).
Results: The results of univariate analysis showed that high NLR, high PLR and low lymphocytes were significantly associated with reduced overall survival (OS) [HR:2.600, 95%CI: 1.008-6.711, P=0.0482; HR: 3.912, 95%CI: 1.427-10.73, P=0.008; HR:4.197, 95%CI: 1.623-10.86, P=0.003]. Furthermore, we contrasted the prediction accuracy of the three models, in which inflammation markers combined with tumor stage prediction accuracy [C-index: 0.803,95%CI: 0.711-0.895] was higher than inflammation markers alone or tumor stage [C-index: 0.735, 95%CI: 0.623-0.847; C-index: 0.787, 95%CI: 0.709-0.865], and constructed a nomogram.
Conclusion: Preoperative inflammatory markers combined with tumor stage can better predict the prognosis of patients with colorectal cancer compared with inflammatory markers or tumor stage alone.