Affiliation:
1. Department of Surgery, Tokyo Generel Hospital, Tokyo, Japan
2. Department of Surgery, Kasai Shoikai Hospital, Tokyo, Japan
Abstract
Background The aim of this study was to investigate the prognostic value of systematic inflammatory response in patients with lymph node-negative colorectal cancer. Methods We retrospectively investigated 245 patients with lymph node-negative colorectal cancer who underwent curative resection and evaluated the prognostic impact of systematic inflammatory response, which was represented by neutrophil-to-lymphocyte ratio (NLR), prognostic nutritional index (PNI), and C-reactive protein-to-albumin ratio (CAR). 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 ≥ .081 ( P = .004) was independent predictors of disease-free survival, while American Society of Anesthesiologists physical status ≥3 ( P = .049) and CAR ≥ .081 ( P < .001) were independent predictors of overall survival. By PSM analysis, PSM-high-CAR was significantly associated with worse disease-free survival ( P = .043) and overall survival ( P = .041) in patients with lymph node-negative colorectal cancer. Conclusions C-reactive protein-to-albumin ratio may be a significant indicator of poor long-term outcomes in patients with lymph node-negative colorectal cancer.