Prognostic value of systemic inflammatory and nutritional markers in patients with resectable colon cancer: a retrospective observational study.

BACKGROUND

Colorectal cancer remains a leading cause of global cancer morbidity. While pathological staging is a cornerstone of prognosis, host-related factors, including systemic inflammatory response and nutritional status, are increasingly recognized as critical determinants of outcomes.

METHODS

This single-center retrospective study investigated the prognostic value of preoperative hematologic markers - neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index, C-reactive protein-to-albumin ratio, prognostic nutritional index (PNI), and the Controlling Nutritional Status score - in 113 patients who underwent radical colectomy between December 2020 and June 2022. The primary and secondary endpoints were 3-year disease-free survival (DFS) and overall survival (OS), respectively.

RESULTS

The cohort demonstrated 3-year DFS and OS rates of 74.1% and 77.0%, respectively, and an overall recurrence rate of 23.9% within the follow-up period. Multivariate Cox analysis identified a high PNI (≥ 43.62) as an independent protective factor for 3-year DFS (hazard ratio [HR] = 0.057, 95% confidence interval [CI]: 0.016-0.125, P < 0.01), and a high PLR (≥ 169.27) as an independent risk factor (HR = 7.910, 95% CI: 2.048-30.558, P < 0.01).

CONCLUSION

Preoperative PNI and PLR are readily accessible, independent prognostic biomarkers for patients with resectable colon cancer. They augment traditional Tumor, Node, Metastasis staging by reflecting the critical balance between pro-tumor inflammation and host immunonutritional status within the tumor microenvironment.