Comparison of nutritional and immunological scoring systems predicting prognosis in T1-2N0 colorectal cancer

Pian, Guangzhe; Oh, Seung Yeop

doi:10.1007/s00384-021-04043-0

Cited by 6 publications

(6 citation statements)

References 28 publications

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“…Although several studies have compared the significance of nutritional markers such as the CONUT score and PNI comprehensively for predicting the survival of patients with CRC, the results are somewhat contradictory. Some studies demonstrated the CONUT score showed better prognostic significance than PNI ( 25 – 27 ) whereas others reported that PNI showed better stratification than the CONUT score ( 24 , 28 ). Although we cannot understand the exact reason for this discordance, different cut-off values of each variable, differences in the sample size, and different disease stages might play a role.…”

Section: Discussionmentioning

confidence: 99%

Combining prognostic nutritional index (PNI) and controlling nutritional status (CONUT) score as a valuable prognostic factor for overall survival in patients with stage I–III colorectal cancer

et al. 2023

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Background and aimsThis study compared the prognostic significance of various nutritional and inflammatory indicators such as neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio and platelet-to-lymphocyte ratio, prognostic nutritional index, and controlling nutritional status score. In addition, we aimed to establish a more accurate prognostic indicator.MethodsWe retrospectively evaluated 1112 patients with stage I–III colorectal cancer between January 2004 and April 2014. The controlling nutritional status scores were classified as low (0–1), intermediate (2–4), and high (5–12) scores. The cut-off values for prognostic nutritional index and inflammatory markers were calculated using the X-tile program. P-CONUT, a combination of prognostic nutritional index and the controlling nutritional status score, was suggested. The integrated areas under the curve were then compared.ResultsThe multivariable analysis showed that prognostic nutritional index was an independent prognostic factor for overall survival, whereas the controlling nutritional status score, neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and platelet-to-lymphocyte ratio were not. The patients were divided into three P-CONUT groups as follows: G1, controlling nutritional status (0–4) and high prognostic nutritional index; G2, controlling nutritional status (0–4) and low prognostic nutritional index; and G3, controlling nutritional status (5–12) and low prognostic nutritional index. There were significant survival differences between the P-CONUT groups (5-year overall survival of G1, G2, and G3 were 91.7%, 81.2%, and 64.1%, respectively; p < 0.0001). The integrated areas under the curve of P-CONUT (0.610, CI: 0.578–0.642) was superior to those of the controlling nutritional status score alone (bootstrap integrated areas under the curve mean difference=0.050; 95% CI=0.022–0.079) and prognostic nutritional index alone (bootstrap integrated areas under the curve mean difference=0.012; 95% CI=0.001–0.025).ConclusionPrognostic effect of P-CONUT may be better than inflammatory markers such as neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio and platelet-to-lymphocyte ratio. Thus, it could be used as a reliable nutritional risk stratification tool in patients with colorectal cancer.

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Section: Discussionmentioning

confidence: 99%

Combining prognostic nutritional index (PNI) and controlling nutritional status (CONUT) score as a valuable prognostic factor for overall survival in patients with stage I–III colorectal cancer

et al. 2023

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“…[ 28 ]. According to a previous study, the NPS was not significantly associated with the prognosis in early-stage CRC [ 11 ]. TNM staging cannot accurately predict the benefit of adjuvant chemotherapy in advanced-stage CRC with lymph node metastasis [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although the NPS has significant impact on survival in CRC, there would be a lot of difference in patients background factors, such as the presence of distant metastasis. In one study examining the utility of NPS in T1-2N0 CRC, the NPS was not correlated with both overall survival (OS) and disease-free survival (DFS) [ 11 ]. Thus, the confounding factors should be minimized to validate the predictive value of the NPS for survival of patients with CRC.…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of the Naples prognostic score in colorectal cancer patients undergoing curative resection: a propensity score matching analysis

Sugimoto¹,

Fukuoka²,

Shibutani³

et al. 2023

BMC Gastroenterol

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Background Systemic inflammation is recognized as a hallmark of cancer that contributes to tumor development and progression in various malignancies. The Naples prognostic score (NPS) was established as a prognostic indicator for colorectal cancer (CRC). This study aims to examine the predictive value of the NPS for survival in CRC patients undergoing curative resection by a propensity score matching (PSM) analysis. Methods A total of 533 CRC patients were enrolled in this study. Overall survival (OS) and disease-free survival (DFS) were compared between high-NPS and low-NPS groups. A time-dependent receiver operator characteristic (ROC) curve analysis was conducted to calculate the area under curve (AUC) of the NPS for OS. A multivariable Cox-proportional hazards regression analysis and PSM analysis were used to identify independent prognostic factors for OS and DFS. We compared the predictive value of the NPS to that of the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), Onodera prognostic nutritional index (PNI), and controlling nutritional status score (CONUT) for OS. Results High-NPS was significantly associated with worse OS and DFS. After PSM, 123 patients were included in each group. A multivariate analysis revealed that Age ≥ 68, ASA-PS ≥ 3, high NPS and undifferentiated tumor type were independently associated with OS, while high NPS, advanced T and N stage were independently associated with DFS after PSM. The NPS had the greatest AUC for OS in comparison to the NLR, LMR, PNI and CONUT. Conclusions We successfully validated the prognostic utility of the NPS for CRC patients after curative resection.

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“…Pretreatment immunological and nutritional statuses have been confirmed to be associated with prognosis of many malignancies. 12,17,18 Increasing evidences have suggested that systemic immune and inflammatory cells, including neutrophils, lymphocytes, and platelets, are associated with the prognosis of a variety of malignancies. 8,10,[19][20][21] One of the mechanism may be related to oxygen free radicals and inflammatory cytokines produced in the inflammatory response, which can promote tumor proliferation, progression, and metastasis, and another possible mechanism is immune suppression.…”

Section: Discussionmentioning

confidence: 99%

“…Pretreatment immunological and nutritional statuses have been confirmed to be associated with prognosis of many malignancies 12,17,18 . Lymphocyte count is the most commonly used indicator of body's immune capacity.…”

Section: Discussionmentioning

confidence: 99%

Prognostic nutritional score based on pretreatment lymphocyte, platelet, and prealbumin predicts prognosis in patients with pancreatic cancer

Liang

Guo

Man

et al. 2023

Journal of Surgical Oncology

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Background and ObjectivesPretreatment immunological indicators and nutritional factors are associated with survival of many malignancies. This study aims to develop a prognostic nutritional score based on a combination of pretreatment lymphocyte, platelet, and prealbumin (Co‐LPPa) in patients with pancreatic cancer (PC) and to investigate the prognostic significance of this score.MethodsPatients who underwent pancreatectomy with a curative intent for PC were retrospectively enrolled. A pretreatment prognostic score was established by immunological indicators and nutritional factors that were independently associated with survival.ResultsPretreatment lymphocyte (<1.6 × 109/L), platelet (<160 × 109/L) and prealbumin (<0.23 g/L) were independently associated with poorer overall survival (OS) and recurrence‐free survival (RFS), and were used to create the Co‐LPPa score. The Co‐LPPa scores were inversely related to OS and RFS, and were able to stratify survival into four groups. The survival differences among the four groups were all significant. Besides, the Co‐LPPa scores could stratify survival independently of pathological prognostic factors. The Co‐LPPa score was superior to prognostic nutritional index and carbohydrate antigen 19‐9 in predicting OS and RFS.ConclusionThe Co‐LPPa score could accurately predict the prognosis of PC patients who underwent curative resection. The score may be helpful for preoperative therapeutic strategies.

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Comparison of nutritional and immunological scoring systems predicting prognosis in T1-2N0 colorectal cancer

Cited by 6 publications

References 28 publications

Combining prognostic nutritional index (PNI) and controlling nutritional status (CONUT) score as a valuable prognostic factor for overall survival in patients with stage I–III colorectal cancer

Combining prognostic nutritional index (PNI) and controlling nutritional status (CONUT) score as a valuable prognostic factor for overall survival in patients with stage I–III colorectal cancer

Prognostic significance of the Naples prognostic score in colorectal cancer patients undergoing curative resection: a propensity score matching analysis

Prognostic nutritional score based on pretreatment lymphocyte, platelet, and prealbumin predicts prognosis in patients with pancreatic cancer

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