Abstract
Background: Tumor status can affect patient prognosis. Prognostic nutritional index (PNI), as a nutritional indicator, is closely related to the prognosis of cancer. However, few studies have examined the combined prognostic value of CEA and PNI in patients. This study investigated the relationship between CEA/PNI and prognosis of colon cancer patients.Methods: A total of 513 patients with stage II–III colon cancer who underwent curative resection at two medical centers from 2009 to 2019 were included. Clinicopathological factors were assessed and overall survival (OS) was assessed in a cohort of 413 patients. Multivariate analysis was used to identify independent prognostic variables to construct histograms predicting 1-year and 3-year OS. Data from 100 independent patients in the validation group was used to validate the prognostic model.Results: The median OS time was 33.6 months, and mortality was observed in 54 patients. Multivariate analysis revealed that preoperative CEA/PNI, lymph node metastasis, peripheral nerve invasion, operation mode, and postoperative chemotherapy were independent factors for prognosis evaluation and thus were utilized to develop the nomogram. The C-index was 0.788 in the learning set and 0.836 in the validation set. The calibration curves reached favorable consensus among the 1-, 3-year OS prediction and actual observation.Conclusion: The combined use of CEA and PNI is an independent prognostic factor and thus can serve as a basis for a model to predict the prognosis of patients with stage II–III colon cancer.
Highlights
The latest global cancer data showed that colorectal cancer is among the top three with the highest incidence and mortality [1,2,3]
PNIlow was highly common in patients with large tumors (≧5 cm), right colon and lymph node metastasis (P < 0.05)
The results revealed that preoperative CEA/Prognostic nutritional index (PNI) is a prognosis-associated marker for patients with colon cancer
Summary
The latest global cancer data showed that colorectal cancer is among the top three with the highest incidence and mortality [1,2,3]. Colon cancer accounts for approximately 65–70% of colorectal cancer cases [4, 5]. Complete surgical resection remains the best treatment for patients with non-metastatic colon cancer. High preoperative CEA level increases the risk of death by 62% compared with preoperative CEA level in non-metastatic colon cancer [9]. Accumulating evidence indicates that nutritional status is associated with survival outcomes in patients with different cancers. 50–80% of admitted patients with malignant cancers are malnourished or at high risk for malnutrition [10,11,12]. Prognostic nutritional index (PNI), as a nutritional indicator, is closely related to the prognosis of cancer. Few studies have examined the combined prognostic value of CEA and PNI in patients. This study investigated the relationship between CEA/PNI and prognosis of colon cancer patients
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