Abstract
Different opinions exist on the relationship between the C-reactive protein-to-albumin ratio (CAR) and the prognosis of colon cancer. This study is aimed at evaluating the relationship between CAR and prognosis of stage II–III colon cancer and establishing a clinical prognosis model. Patients were randomised to a training set (566 cases) and validation set (110 cases). The relationship between CAR and clinicopathological variables was calculated, and the Kaplan-Meier method was used to analyse the overall survival (OS) rate of colon cancer. In the training set, colon cancer independent risk factors were included in the prognosis model and then tested in the validation set. The accuracy and discrimination of the model were assessed using the C-index and calibration curves. Compared with patients with low CAR, patients with high CAR showed significantly poorer survival (P = 0.020). In the multivariate analysis, CAR, carcinoembryonic antigen (CEA), lymph node metastasis, operation mode, and perineural invasion were identified as independent prognostic indicators and adopted to establish the prediction model. The C-index of the nomogram for predicting OS reached 0.751 in the training set and 0.719 in the validation set. The calibration curve exhibited good consistency. In the present study, the CAR may be an independent prognostic factor for stage II–III colon cancer, and the nomogram has a certain predictive value. However, further prospective large-sample research needs to be conducted to validate our findings.
Highlights
Colon cancer has the fourth highest incidence of all tumours and is the fifth leading cause of cancer deaths worldwide [1]
Considerable attention has been paid to preoperative biomarkers and tumour prognosis evaluation
Patients with stage I CC have a good prognosis; those with stage IV CC who present with an inflammatory response carry tumours with more aggressive biological behaviour and poorer survival [6]
Summary
Colon cancer has the fourth highest incidence of all tumours and is the fifth leading cause of cancer deaths worldwide [1]. Considerable attention has been paid to preoperative biomarkers and tumour prognosis evaluation. Systemic inflammatory biomarkers, such as PLR, NLR, and C-reactive protein-to-albumin ratio (CAR), have been recently reported to be closely related to a patient’s prognosis in colorectal carcinoma (CC), but the relationship is not well defined [2,3,4,5]. Our group determined that combining factors would allow better prognostic prediction Because these biomarkers are obtained from routine preoperative examinations, they have attracted increasing attention. To our knowledge, this is the first time that our hospital has established a model to evaluate the prognosis of patients with CC
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