The advanced lung cancer inflammation index predicts short and long-term outcomes in patients with colorectal cancer following surgical resection: a retrospective study

Hailun Xie; Shizhen Huang; Guanghui Yuan; Jiaan Kuang; Ling Yan; Lishuang Wei; Shuangyi Tang; Jialiang Gan

doi:10.7717/peerj.10100

The advanced lung cancer inflammation index predicts short and long-term outcomes in patients with colorectal cancer following surgical resection: a retrospective study

PeerJ. 2020 Oct 8:8:e10100. doi: 10.7717/peerj.10100. eCollection 2020.

Authors

Hailun Xie¹, Shizhen Huang¹, Guanghui Yuan¹, Jiaan Kuang¹, Ling Yan¹, Lishuang Wei², Shuangyi Tang³, Jialiang Gan¹

Affiliations

¹ Department of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, P.R. China.
² Department of Respiratory Medicine, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, P.R. China.
³ Department of Pharmacy, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, P.R. China.

Abstract

Background and purpose: Several studies have proposed that the advanced lung cancer inflammation index (ALI), a new inflammation-related index, can be used for the prognosis assessment of various malignancies. However, few studies have reported its prognostic value in colorectal cancer (CRC). Therefore, this study explored the relationship between ALI and outcomes in CRC patients.

Methods: A total of 662 CRC patients who underwent surgery between 2012 and 2014 were included. The ALI was defined as: body mass index × serum albumin/neutrophil to lymphocyte ratio. The X-tile program identified the optimal cut-off value of ALI. Logistic regression analyses determined factors affecting postoperative complications. The Kaplan-Meier method and Cox proportional hazards analyses evaluated potential prognostic factors.

Results: The optimal cut-off of ALI in males and females were 31.6 and 24.4, respectively. Low-ALI was an independent risk factor for postoperative complications in CRC patients (odds ratio: 1.933, 95% CI [1.283-2.911], p = 0.002). Low-ALI groups also had significantly lower progression-free survival (PFS) and overall survival (OS), when compared with the high-ALI group, especially at advance tumor stages. Using multivariate analysis, ALI was determined as an independent prognostic factor for PFS (hazard ratio: 1.372, 95% CI [1.060-1.777], p = 0.016) and OS (hazard ratio: 1.453, 95% confidence interval: 1.113-1.898, p = 0.006).

Conclusion: ALI is an independent predictor of short and long-term outcomes in CRC patients, especially at advance tumor stages. The ALI-based nomograms can provide accurate and individualized prediction of postoperative complication risk and survival for CRC patients.

Keywords: Advanced lung cancer inflammation index; Colorectal cancer; Complication; Prognosis.

Grants and funding

This research was supported by the 2019 Innovation Project of Guangxi Graduate Education (JGY2019052). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.