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

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Abstract

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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Abbreviations

CRC:

Colorectal cancer

OS:

Overall survival

DFS:

Disease-free survival

TNM stage:

Tumor node metastasis stage

mGPS:

Modified Glasgow Prognostic Score

PNI:

Prognostic Nutritional Index

CRP:

C-reactive protein

TLC:

Total lymphocyte counts

OPS:

Osaka Prognostic Score

TS:

Training set

VS:

Validation set

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Acknowledgements

The authors would like to thank Ms. Aya Ito for special technical assistance and Dr Trish Reynolds, MBBS, FRACP, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

Funding

This work was supported in part by a grant-in-aid for scientific research (C, 41040220, 17K16542) and a 38th Japan Medical Woman’s Association Academic Research Grant.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Shiki Fujino, Norikatsu Myoshi, Kazuhiro Saso, Msaru Sasaki, Satoshi Ishikawa, Taishi Hata, Chu Matsuda, Tsunekazu Mizushima & Yuichiro Doki

  2. Department of Surgery, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, 537-8511, Japan

    Yusuke Takahashi, Masayoshi Yasui & Masayuki Ohue

  3. Innovative Oncology Research and Regenerative Medicine, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, 537-8511, Japan

    Norikatsu Myoshi

  4. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Masaki Mori

Authors
  1. Shiki Fujino
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  2. Norikatsu Myoshi
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Correspondence to Norikatsu Myoshi.

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Fujino, S., Myoshi, N., Saso, K. et al. The inflammation–nutrition score supports the prognostic prediction of the TNM stage for colorectal cancer patients after curative resection. Surg Today 50, 163–170 (2020). https://doi.org/10.1007/s00595-019-01861-2

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  • DOI: https://doi.org/10.1007/s00595-019-01861-2

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