The prognostic value of the systemic inflammatory response in patients with lymph node- negative colorectal cancer

Abstract

Abstract Purpose The systematic inflammatory response has been associated with tumor progression, metastasis, and poor prognosis in patients with colorectal cancer. This study investigated the prognostic value of the systematic inflammatory response in patients with lymph node-negative colorectal cancer.Methods This study comprised 245 patients with lymph node-negative colorectal cancer who underwent curative resection. We evaluated the value of systematic inflammatory response, which was represented by neutrophil–lymphocyte ratio, (NLR), prognostic nutritional index (PNI) and C-reactive protein–albumin ratio (CAR). Univariate and multivariate Cox proportional hazards regression analyses were performed to assess independent risk factors for poor survival in patients with lymph node-negative colorectal cancer. Then, the prognostic significance of the systematic inflammatory response on survival was analyzed using the Kaplan-Meier method in patients selected by propensity score matching (PSM) analysis.Results In the multivariate analysis, CAR ≥ 0.081 (P = 0.004) was independent predictors of disease-free survival. While, in the multivariate analysis, American Society of Anesthesiologists physical status ≥ 3 (P = 0.049), and CAR ≥ 0.081 (P < 0.001) were independent predictors of overall survival. Applying PSM analysis, the patients were divided into PSM-high-CAR (n = 67) and PSM-low-CAR (n = 67) groups. PSM-high-CAR was significantly associated with worse disease-free survival (P = 0.041) and overall survival (P = 0.043) in patients with lymph node-negative colorectal cancer.Conclusions CAR may be a significant indicator of poor long-term outcomes in patients with lymph node-negative colorectal cancer, suggesting the significance of the complex interaction between the tumor and the host inflammatory response in patients with colorectal cancer.