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

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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… Click to show full abstract

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: rectal cancer; patients colorectal; cancer; colon rectal; colorectal cancer; patients colon

Journal Title: Cancer Management and Research
Year Published: 2020

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