Association between preoperative neutrophil percentage-to-albumin ratio and survival outcomes in patients with colorectal cancer undergoing radical surgery: a retrospective study with external validation - Report - MDSpire
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Link Between Preoperative Neutrophil-to-Albumin Ratio and Survival in Colorectal Cancer Patients Undergoing Radical Surgery: A Retrospective Analysis with External Validation
Clinical Report: Link Between Preoperative Neutrophil-to-Albumin Ratio and Survival in Colorectal Cancer Patients
Overview
This study investigates the association between preoperative neutrophil-to-albumin ratio (NPAR) and survival outcomes in colorectal cancer (CRC) patients undergoing radical surgery. Higher NPAR correlates with shorter overall survival (OS) and disease-free survival (DFS).
Background
Colorectal cancer (CRC) is a leading cause of cancer-related mortality globally, with radical surgery being the primary treatment. Accurate preoperative risk stratification is essential for optimizing treatment and improving outcomes. Traditional staging systems may not adequately account for systemic inflammatory responses and nutritional status.
Data Highlights
Variable
HR (95% CI)
p-value
OS (Training Cohort, 1-SD increase in NPAR)
2.19 (1.90–2.53)
< 0.001
DFS (Training Cohort, 1-SD increase in NPAR)
1.88 (1.62–2.19)
< 0.001
OS (External Cohort, 1-SD increase in NPAR)
1.21 (1.08–1.35)
< 0.001
DFS (External Cohort, 1-SD increase in NPAR)
1.24 (1.12–1.37)
< 0.001
Key Findings
Higher preoperative NPAR is associated with adverse clinicopathological features.
Each 1-SD increase in NPAR correlates with shorter OS (HR 2.19) and DFS (HR 1.88) in the training cohort.
In the external cohort, the association remains significant but attenuated for both OS (HR 1.21) and DFS (HR 1.24).
Adding NPAR to baseline models did not significantly improve predictive discrimination for OS and showed limited value for DFS.
Clinical Implications
Preoperative NPAR may serve as a marker reflecting inflammatory and nutritional status in CRC patients. Its predictive value beyond established clinicopathological factors requires further validation.
Conclusion
The study confirms an association between preoperative NPAR and survival outcomes in CRC patients.
