The prognostic value of combined tumor markers and systemic immune-inflammation index in colorectal cancer patients

Langenbecks Arch Surg. 2020 Dec;405(8):1119-1130. doi: 10.1007/s00423-020-01963-3. Epub 2020 Aug 13.

Abstract

Purpose: This study evaluated the significance of combining tumor markers (TM) and systemic immune-inflammation index (SII) for postoperative complications and long-term outcomes in colorectal cancer (CRC) patients.

Methods: CRC patients (662) who underwent surgery between 2012 and 2014 were retrospectively enrolled into our study. Factors affecting postoperative complications were evaluated by logistic regression analysis. Prognostic factors were assessed using Kaplan-Meier and Cox proportional hazards models. Nomograms were constructed to predict the risk of postoperative complications and survival. A consistency index and a calibration curve were used to evaluate the predictive accuracy of nomograms.

Results: TM-SII score was established by combining TM and SII. Logistic regression analyses showed that TM-SII score was an important predictor of postoperative complications in CRC patients. Kaplan-Meier analyses showed that TM-SII score was favorable for prognostic risk stratification. In addition, multivariate analyses indicated that TM-SII score was an independent prognostic indicator for disease-free survival and overall survival. TM-SII based nomograms had a moderate prediction accuracy.

Conclusion: TM-SII score is a good prognostic indicator for CRC patients. It may be used as a useful risk stratification tool for advanced CRC patients. TM-SII-based nomograms could be used to identify CRC patients with poor outcomes.

Keywords: Colorectal cancer; Postoperative complications; Prognosis; Systemic immune-inflammation index; Tumor markers.

MeSH terms

  • Biomarkers, Tumor*
  • Colorectal Neoplasms* / surgery
  • Humans
  • Inflammation
  • Prognosis
  • Retrospective Studies

Substances

  • Biomarkers, Tumor