Baseline serum albumin and other common clinical markers are prognostic factors in colorectal carcinoma

Gonzalez-Trejo, Sagrario; Carrillo, José F.; Carmona-Herrera, Doris; Baz-Gutiérrez, Patricia; Herrera‐Goepfert, Roberto; Nunez, Gloria; Ochoa‐Carrillo, Francisco Javier; Gallardo‐Rincón, Dolores; Aiello-Crocifoglio, Vincenzo; Oñate‐Ocaña, Luis F.

doi:10.1097/md.0000000000006610

Cited by 39 publications

(32 citation statements)

References 26 publications

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“…However, OS cannot be completely explained by TNM stages or by the currently established prognostic factors . In CRC, several prognostic factors improving the prognostic value of the TNM classification have been described . However, more refined tools are needed to further increase their prognostic value.…”

Section: Introductionmentioning

confidence: 99%

“…4 In CRC, several prognostic factors improving the prognostic value of the TNM classification have been described. [5][6][7] However, more refined tools are needed to further increase their prognostic value. The Memorial Sloan-Kettering Cancer Center model, which was designed to predict the 5-and 10-year disease-free survival after curative resection in patients with colon cancer, or the European CanCer Organisation/European Society of Surgical Oncology nomograms predicting recurrence, distant metastases and OS, 8,9 have been important contributions to the field.…”

Section: Introductionmentioning

confidence: 99%

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Association of the prognostic nutritional index and overall survival in patients with colorectal cancer: A STROBE compliant retrospective cohort study

et al. 2019

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Background The TNM classification does not completely reflect the prognosis of patients with colorectal cancer (CRC). Several clinical factors have been used to increase its prognostic value, but factors pertaining to the patient's immunonutritional status have not usually been addressed. The aim of this study is to evaluate the role of Prognostic nutritional index (PNI) and other well‐known prognostic factors by multivariate analysis in a cohort of patients with CRC. Methods This is a retrospective cohort study of consecutive patients with CRC managed in a cancer center between January 1992 and December 2016. Cox's model was used to define the association of the PNI and other factors with Overall survival (OS). Results A total of 3301 patients were included: 47.7% were female and 52.3% were male, with a mean age of 58.7 years. By bivariate analysis, PNI was strongly associated with OS (Risk ratio [RR] 0.968, 95% Confidence interval [CI] 0.962‐0.974; P < 0.001). On multivariate analysis, PNI was an independent explanatory variable (as continuous variable and as categorized variable; RR 0.732, 95% CI 0.611‐0.878; RR 0.656, 95% CI 0.529‐0.813 and RR 0.646, 95% CI 0.521‐0.802, for quintiles 2, 3, and 4‐5, respectively); a biological gradient effect was demonstrated. The final prognostic model included PNI, location of the neoplasia in the colorectum, basal hemoglobin, lymphocyte count, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, TNM stage, differentiation degree, R classification, and postoperative complications. Conclusions PNI is a significant and independent prognostic factor in patients with CRC. Its prognostic value adds precision to the TNM staging system including specific subgroups of patients with CRC; it should be evaluated in prospective clinical studies.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of the prognostic nutritional index and overall survival in patients with colorectal cancer: A STROBE compliant retrospective cohort study

et al. 2019

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“…At the same time, there is growing evidence that circulating blood inflammatory markers, such as the neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), the lymphocyte-monocyte ratio (LMR), C-reactive protein, haptoglobin and albumin, are correlated with the diagnosis or prognosis of CRC. [11][12][13][14][15] The NLR and PLR have been reportedly found to be associated with invasion depth and tumor stage and can be used for the early diagnosis and outcome prediction of CRC patients. 16 The LMR has also been reported to be related to tumor differentiation grade and metastasis and can thus provide valuable information about diagnosis and prognosis in colorectal cancer.…”

Section: Introductionmentioning

confidence: 99%

<p>Potential Diagnostic Value Of Combining Inflammatory Cell Ratios With Carcinoembryonic Antigen For Colorectal Cancer</p>

Li¹,

Guo²,

Chu³

et al. 2019

CMAR

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To evaluate the diagnostic value of combining the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) or lymphocyte-monocyte ratio (LMR) with carcinoembryonic antigen (CEA) in patients with colorectal cancer (CRC). Patients and methods: The diagnostic performance of inflammatory makers and CEA was evaluated in cohort 1 (664 patients with CRC, 336 patients with colorectal polyps and 664 healthy controls) and validated in cohort 2 (87 patients with CRC and 87 healthy controls) by using receiver operating characteristic curve analysis. Results: In cohort 1, the NLR, PLR and CEA levels were significantly higher, while the LMR was markedly lower in patients with CRC than in healthy controls. The PLR and LMR were significantly associated with invasion depth and lymph node metastasis. Moreover, significant differences in the PLR and LMR were observed between patients with stage I/II CRC and healthy or polyp controls and those with stage III/IV CRC. Using the NLR, PLR or LMR with CEA resulted in a significantly larger area under the curve (AUC) than any of them used alone. Combining the PLR and LMR with CEA exhibited the best diagnostic value for CRC (AUC=0.892). The AUCs of this combination were 0.864 and 0.783 for distinguishing stage I/II CRC from healthy and polyp controls, respectively. When we used the same cutoff values to assess the diagnostic ability of these markers in cohort 2, similar results were observed, and the PLR, LMR and CEA combination also showed the highest accuracy (AUC=0.936). Conclusion: Combining inflammatory cell ratios with CEA could improve the diagnostic efficacy for CRC patients. The combination of the PLR and LMR with CEA might be a valuable indicator in the early detection and monitoring of CRC patients.

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“…(34) As for albumin, previous studies have investigated that albumin is an independent prognostic factor in CRC and hypoalbuminemia was associated with poor survival with CRC. (8,35,36) Nomogram is considered a reliable tool to quantify cancer risk than TNM staging system classi cation. (37) Previous studies have developed nomograms to predict the clinical outcomes of CRC patients.…”

Section: Discussionmentioning

confidence: 99%

A Prospective and Nutrition-Related Nomogram Model for Prognosis in Colorectal Cancer Survival: A Multicenter Cohort Study in China

Ruan

Zhang

et al. 2020

Preprint

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BackgroundColorectal cancer (CRC) is a common malignancy with high incidence of malnutrition. Increasing evidence showed that nutritional status could be a prognostic indicator of cancer survival. However, there were few prognostic models involving nutrition-related indicators in CRC. This study aimed to develop a nutrition-related prognostic model for CRC survival.MethodsThis multicenter retrospectively primary cohort data included 1,373 CRC patients, and the external validation cohort enrolled other 108 CRC patients. LASSO and multivariate regression analyses were used to select prognostic indicators and develop the nomogram. We performed C-index, calibration curves, and DCA to assess the discrimination, calibration, and applicability. Finally, the indicators of the nomogram model were used as adjustment factors. Multivariate Cox survival analyses were performed to investigate the benefit of the Patient-Generated Subjective Global Assessment (PG-SGA) and Global Leadership Initiative on Malnutrition (GLIM) malnutrition criteria to CRC prognosis.ResultsFive prognostic indicators (TNM stage, radical resection, reduced food intake, activities and function decline, and low albumin) were chosen to develop the nomogram. C-index of the nomogram was 0.74 (95% CI 0.72-0.77) and 0.72 (95% CI 0.62-0.81) in the primary cohort and validation cohort, which were higher than other models. Calibration plots and DCA showed that the nomogram model has a good consistency and clinical benefit in predicting CRC survival. Multivariate Cox survival analysis suggested moderate (P<0.05, HR 1.32, 95% CI 1.002-1.75) and severe malnutrition (P<0.001, HR 1.69, 95% CI 1.27-2.25) were associated with worse overall survival (OS) in CRC using the PG-SGA criteria. However, there was no prognostic significance in GLIM criteria (all P>0.05). Finally, stratified analysis suggested that malnourished CRC patients with low albumin synergistically increased the death risk of CRC OS both in PG-SGA and GLIM. (P for interaction = 0.007 and 0.004, respectively)ConclusionThis study established a prospective model to predict the OS in CRC patients using nutrition-related indicators. Moreover, we also found that PG-SGA had a better prognostic and predictive efficiency in CRC than GLIM. These findings grant further verification.

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Baseline serum albumin and other common clinical markers are prognostic factors in colorectal carcinoma

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Cited by 39 publications

References 26 publications

Association of the prognostic nutritional index and overall survival in patients with colorectal cancer: A STROBE compliant retrospective cohort study

Association of the prognostic nutritional index and overall survival in patients with colorectal cancer: A STROBE compliant retrospective cohort study

<p>Potential Diagnostic Value Of Combining Inflammatory Cell Ratios With Carcinoembryonic Antigen For Colorectal Cancer</p>

A Prospective and Nutrition-Related Nomogram Model for Prognosis in Colorectal Cancer Survival: A Multicenter Cohort Study in China

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