Prognostic Value of Combined Preoperative Carcinoembryonic Antigen and Prognostic Nutritional Index in Patients With Stage II–III Colon Cancer

Abstract

Background: Tumor status can affect patient prognosis. Prognostic nutritional index (PNI), as a nutritional indicator, is closely related to the prognosis of cancer. However, few studies have examined the combined prognostic value of CEA and PNI in patients. This study investigated the relationship between CEA/PNI and prognosis of colon cancer patients.Methods: A total of 513 patients with stage II–III colon cancer who underwent curative resection at two medical centers from 2009 to 2019 were included. Clinicopathological factors were assessed and overall survival (OS) was assessed in a cohort of 413 patients. Multivariate analysis was used to identify independent prognostic variables to construct histograms predicting 1-year and 3-year OS. Data from 100 independent patients in the validation group was used to validate the prognostic model.Results: The median OS time was 33.6 months, and mortality was observed in 54 patients. Multivariate analysis revealed that preoperative CEA/PNI, lymph node metastasis, peripheral nerve invasion, operation mode, and postoperative chemotherapy were independent factors for prognosis evaluation and thus were utilized to develop the nomogram. The C-index was 0.788 in the learning set and 0.836 in the validation set. The calibration curves reached favorable consensus among the 1-, 3-year OS prediction and actual observation.Conclusion: The combined use of CEA and PNI is an independent prognostic factor and thus can serve as a basis for a model to predict the prognosis of patients with stage II–III colon cancer.

Combined preoperative prognostic nutritional index and D-dimer score predicts outcome in colorectal cancer

“…For example, Uejima et al included 135 stage II patients and found that a combination of PNI and CEA exhibited good prognostic efficacy, but the 5-year DFS rates in the CEA low /PNI high , CEA high /PNI high and CEA low /PNI low groups were 100%, 100% and 97.4%, respectively, making it difficult to distinguish the survival differences [ 43 ]. Similarly, Xu et al enrolled 513 stage II–III patients and reported that PNI and CEA represent a superior combination, but the 1- and 3-year OS rates in the aforementioned patient subgroups were undistinguishable [ 44 ]. Taking into account these results, it was suggested that an additional indicator that was more reliable than CEA was needed.…”

“…In our study, the 3-year OS rates in the PDS 0, 1 and 2 subgroups were 95.35%, 75.51% and 59.62%, respectively (P < 0.001), and could be effectively separated. However, when patients were divided into 4 subgroups (PNI high /DD low , PNI high /DD high , PNI low /DD low and PNI low /DD high ) as noted in previous studies (only those stage II–III) [ 43 , 44 ], the 3-year OS rates were 95.35%, 80.95%, 71.43%, and 58.82%, respectively (P = 0.001, data not shown), and it was also difficult to separate the survival differences among the subgroups except for the comparisons between the PNI high /DD low and PNI low /DD high as well as the PNI high /DD high and PNI low /DD high subgroups. These results were partly consistent with previous studies [ 43 , 44 ].…”

Surgical excision and radiotherapy for brain metastasis from colorectal cancer: How frailty and comorbidity indices influence outcome

“…[10][11][12][13] Comorbidity indices, such as the Recursive Partitioning Analysis (RPA) class, the 5-item modified frailty index (MFI-5) and prognostic nutritional index (PNI), have been increasingly utilized in both oncological and neurosurgical practices to represent a comprehensive comorbidity status that aims to improve the prediction of prognosis. [14][15][16][17][18] For instance, a higher MFI-5 score predicted worse early outcomes and 30-day readmissions following CRC surgeries. 19,20 The PNI has been shown to be a prognostic indicator for survival in patients with BM from non-small cell lung cancer and glioblastoma.…”

Combination of Geriatric Nutritional Risk Index and Carcinoembryonic Antigen to Predict the Survival of Patients With Colorectal Cancer

“…In China, the incidence of CRC ranks fourth among all malignancies and the mortality ranks fifth (3). Advances in treatment methods such as surgery, chemoradiotherapy, immunotherapy, and targeted therapy have improved the prognosis of CRC; however, many CRC patients experience distant metastasis or local recurrence after receiving anticancer therapy (4)(5)(6)(7). The survival rate of CRC patients with recurrence and metastasis can be reduced to 5-10% (8,9).…”