Novel and Simple Nomograms Using Inflammation and Nutritional Biomarkers for Stage II–III Colon Cancer, Taking “Time after Curative Surgery” into Consideration

Abstract

Purpose Recurrence of colon cancer is associated with time after curative surgery. This study aimed to construct novel nomograms to predict relapse-free survival (RFS) in stage II–III colon cancer, considering “time after surgery” and using various inflammatory and nutritional biomarkers. Methods All 542 patients who underwent radical surgery for stage II–III colon cancer between January 2000 and August 2015 at our institute were retrospectively analyzed. Time-dependent receiver operating characteristic curves and cutoff values were obtained for neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio, platelet-lymphocyte ratio, Japanese modified Glasgow prognostic score (mGPS), C-reactive protein-albumin ratio (CAR), prognostic nutritional index, and controlling nutritional status (CONUT) for each postoperative period (1 − 5 years). We used Cox proportional hazard analyses to evaluate independent risk factors and to construct nomograms in each period. Results We obtained a good accuracy in NLR, CAR, mGPS, and CONUT (area under the curve > 0.5). NLR was the only preoperative independent risk factor, except age, in multivariate analysis. We constructed the nomograms and obtained a good discrimination value of the concordance index in each period (>0.75). Conclusion Using inflammatory and nutritional biomarkers, we established and calibrated novel nomograms for predicting time-dependent RFS for stage II–III colon cancer patients.