4.3 Article

The inflammation-nutrition score supports the prognostic prediction of the TNM stage for colorectal cancer patients after curative resection

Journal

SURGERY TODAY
Volume 50, Issue 2, Pages 163-170

Publisher

SPRINGER
DOI: 10.1007/s00595-019-01861-2

Keywords

Colorectal cancer; Nomogram; Nutrition; Inflammation; Prognostic score

Categories

Funding

  1. 38th Japan Medical Woman's Association Academic Research Grant [41040220, 17K16542]
  2. Grants-in-Aid for Scientific Research [17K16542] Funding Source: KAKEN

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Purpose Inflammation and the nutritional and immunologic status are known to be associated with the prognosis of malignant tumors. We aimed to examine inflammation-nutrition scores and predict the prognosis of colorectal cancer (CRC) patients by integrating nutritional and immunologic factors and tumor stage. Methods This study investigated 511 patients with CRC from 2007 to 2013: 380 in a training set (TS) and 131 in a validation set (VS). The Osaka Prognostic Score (OPS) used comprised 1 point each for C-reactive protein > 1.0 mg/dL, albumin (< 3.5 g/dL), and lymphocyte count < 1600. Patients were classified according to the total points. The modified Glasgow Prognostic Score and the Prognostic Nutritional Index were also examined. A nomogram for predicting the disease-free survival (DFS) and overall survival (OS) was constructed based on the OPS and TNM stage. Results In the TS, a high OPS and high TNM stage were significant predictors of the DFS and OS. The C-indexes of the OPS for the DFS and OS were higher than those of other reported scoring systems. The C-index of the nomogram for the DFS was 0.762 in the TS and 0.675 in the VS. The C-index of the nomogram for the OS was 0.805 in the TS and 0.743 in the VS. Conclusion Integrating the TNM stage and OPS accurately predicted the prognosis of patients with CRC.

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