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Impact of Nutritional Indices on the Survival Outcomes of Patients with Colorectal Cancer

Authors Hu Z, Li Y, Mao W, Chen B, Yang L, Meng X

Received 20 December 2019

Accepted for publication 15 March 2020

Published 26 March 2020 Volume 2020:12 Pages 2279—2289


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Eileen O'Reilly

Zhengyu Hu,1,* Yan Li,2,* Weipu Mao,3 Bo Chen,1 Lin Yang,2 Xiangling Meng1

1Department of Gastrointestinal Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province 230032, People’s Republic of China; 2Department of Radiation Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province 230032, People’s Republic of China; 3Department of Urology, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai 200072, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Xiangling Meng Tel +86-551-62922035
Fax +86-551-62922049
Lin Yang Tel/ Fax +86-551-62923545

Background: The effect of preoperative nutritional status on the survival of patients with colorectal cancer is still unknown. The purpose of our study was to examine the impact of the prognostic nutritional index (PNI), prealbumin (PAB) and the albumin to globulin ratio (AGR) on survival outcomes in patients with colon and rectal cancer.
Methods: Between January 2012 and December 2013, 361 patients with colorectal cancer who underwent curative surgery in the survey and various clinical and haematological parameters were recorded. The optimal cut-off values of the PNI, PAB and AGR were determined by MedCalc software, and Cox regression analysis was performed to investigate the effect of the PNI, PAB and AGR on the overall survival (OS) of patients with colon and rectal cancer.
Results: In patients with colon and rectal cancer, a high PNI, PAB, and AGR correlate with higher survival times. Receiver operating characteristic (ROC) curve analysis showed that at most time points, the PNI has a higher area under the curve (AUC) in predicting colon and rectal cancer OS. Multivariate Cox regression analysis showed that of the PNI, PAB and AGR, only the PNI was an independent risk factor for OS in patients with colon and rectal cancer. Patients with a high PNI were predicted to have higher OS (hazard ratio [HR]: 0.479; 95% confidence interval [CI]: 0.233– 0.985; P = 0.045) in colon cancer and higher OS (HR: 0.225; 95% CI: 0.111– 0.454; P < 0.001) in rectal cancer compared with patients with a low PNI.
Conclusion: Preoperative PNI, PAB and AGR may be predictors of OS in patients with colon and rectal cancer after radical surgery, especially the PNI, which has a good ability to predict OS in both tumours.

Keywords: PNI, PAB, AGR, colon cancer, rectal cancer, overall survival

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