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The prognostic value of the prognostic nutritional index and inflammation-based markers in obstructive colorectal cancer

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Abstract

Purpose

Inflammation-based markers predict long-term outcomes of various malignancies. We investigated the relationship between these markers and the long-term survival in obstructive colorectal cancer (OCRC) patients with self-expandable metallic colonic stents (SEMSs) who subsequently received curative surgery.

Methods

We retrospectively analyzed 72 consecutive pathological stage II and III OCRC patients between 2013 and 2019. The prognostic significance of the prognostic nutritional index (PNI), neutrophil–lymphocyte ratio (NLR), lymphocyte–monocyte ratio (LMR), and platelet–lymphocyte ratio (PLR) was evaluated.

Results

The overall survival (OS), cancer-specific survival, and disease-free survival (DFS) were significantly shorter in the PNI < 35 group than in the PNI ≥ 35 group (p = 0.006, p < 0.001, and p = 0.003, respectively), and multivariate analyses revealed the PNI to be the only inflammation-based marker independently associated with the survival. A PNI < 35 was significantly associated with an elevated CA 19–9 level (p = 0.04) and longer postoperative hospital stay (p = 0.03). Adjuvant chemotherapy was also significantly associated with the OS (p = 0.040) and DFS (p = 0.011) in multivariate analyses.

Conclusion

The results showed that the PNI was a potent prognostic indicator. For OCRC patients, both systemic inflammation and the nutrition status seem to be important for predicting the prognosis, and administering adjuvant chemotherapy was very important.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Sendai City Medical Center Sendai Open Hospital, 5-22-1 Tsurugaya, Miyagino-ku, Sendai, 983-0824, Japan

    Ryuichiro Sato, Masaya Oikawa, Tetsuya Kakita, Takaho Okada, Tomoya Abe, Takashi Yazawa, Haruyuki Tsuchiya, Naoya Akazawa, Masaki Sato & Takashi Tsuchiya

  2. Department of Gastroenterology, Sendai City Medical Center Sendai Open Hospital, 5-22-1 Tsurugaya, Miyagino-ku, Sendai, 983-0824, Japan

    Tetsuya Ohira, Yoshihiro Harada, Haruka Okano & Kei Ito

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  1. Ryuichiro Sato
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  2. Masaya Oikawa
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Correspondence to Ryuichiro Sato.

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Sato, R., Oikawa, M., Kakita, T. et al. The prognostic value of the prognostic nutritional index and inflammation-based markers in obstructive colorectal cancer. Surg Today 50, 1272–1281 (2020). https://doi.org/10.1007/s00595-020-02007-5

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  • DOI: https://doi.org/10.1007/s00595-020-02007-5

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