Increasing evidence indicates that inflammation plays a vital role in tumorigenesis and progression. However, the prognostic value of inflammatory biomarkers in colorectal cancer (CRC) has not been established. In this study, a retrospective analysis was conducted in patients with CRC in Fudan University Shanghai Cancer Center (FUSCC) between April 1, 2007 and April 30, 2014, and 5,336 patients were identified eligible. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and albumin/globulin ratio (AGR) were analyzed. Kaplan-Meier analysis was used to calculate the 5-year overall survival (OS) and disease-free survival (DFS). Cox regression analysis was performed to assess the prognostic factors. Nomograms were established to predict OS and DFS, and Harrell's concordance index (c-index) was adopted to evaluate prediction accuracy. As results, the 5-year OS was 79.2% and the 5-year DFS was 56.0% in the cohort. Patients were stratified into 2 groups by NLR (2.72 and >2.72), PLR (219.00 and >219.00), LMR (2.83 and >2.83) and AGR (<1.50 and 1.50). Patients with NLR > 2.72, PLR > 219.00, LMR 2.83 and AGR < 1.50 were significantly associated with decreased OS and DFS (p < 0.001). Multivariate analysis indicated that NLR, LMR and AGR were independent factors of OS (p 5 0.047, p 5 0.008 and p < 0.001, respectively) and DFS (p 5 0.009, p < 0.001 and p 5 0.008, respectively). In addition, nomograms on OS and DFS were established according to all significant factors, and c-indexes were 0.765 (95% CI: 0.744-0.785) and 0.735 (95% CI: 0.721-0.749), respectively. Nomograms based on OS and DFS can be recommended as practical models to evaluate prognosis for CRC patients.Colorectal cancer (CRC) is the third most commonly diagnosed cancer in males and the second in females.1 The estimated global 5-year prevalence rate of CRC was 68.2/100,000, and cancer death rate caused by CRC was about 8.5%. 2 Compared with developed countries, the 5-year prevalence rate of CRC is significantly lower in China (52.7/100,000), but the mortality-to-prevalence ratio (MPR) of CRC in China (14%) is a lot higher, 2 which indicates that the overall survival outcome of CRC is apparently worse in China. Surgical resection remains the only curative treatment option for colorectal cancer. However, a considerable proportion of CRC patients develop recurrence or metastasis within 5 years after surgical treatment. Thus, a better model to predict the prognosis of CRC patients after radical resection is urgently needed.
