Significance of Naples prognostic score for postoperative complications after colorectal cancer surgery.

PURPOSE: The Naples prognostic score (NPS) is a sensitive scoring system that reflects both inflammatory and nutritional status. This study examined the significance of NPS in predicting postoperative complications following colorectal cancer surgery.

METHODS

The present study included data from 443 patients who underwent curative resection for colorectal cancer. The patients were classified into low NPS (score 0-2) and high NPS (score 3-4) groups. We retrospectively investigated the relationship between NPS and postoperative complications (Clavien-Dindo classification ≥ II).

RESULTS

Among all patients, 57 (13%) developed postoperative complications. A total of 340 patients (77%) were categorized into the low NPS group and 103 (23%) were categorized into the high NPS group. A multivariate analysis identified that high NPS (P < 0.001), tumor location in the rectum (P = 0.025), longer operation time (P = 0.027), and greater blood loss (P = 0.004) were independent risk factors for postoperative complications. Furthermore, high NPS was significantly associated with older age (P < 0.001), higher American Society of Anesthesiologists physical status score (P = 0.029), advanced T stage (P < 0.001), N stage (P = 0.036), and longer length of hospital stay (P < 0.010).

CONCLUSIONS

NPS is a strong predictor of poor outcomes in patients undergoing curative resection for colorectal cancer, suggesting the importance of systemic inflammation and the nutritional status.