Ender DOĞAN, Sedat Tarık FIRAT, Murat ESER, Oktay BOZKURT, Mevlüde İNANÇ, Metin ÖZKAN

Prognostic significance of prognostic nutritional index and hemoglobin to red cell distribution width ratio in metastatic colorectal cancer patients

Aims: Malnutrition and systemic inflammation are poor prognostic factors in cancer. Prognostic nutritional index (PNI) and Hemoglobin to red blood cell distribution witdh (HRR) are considired indicators of malnutrition and systemic inflammation. We aimed to investigate the prognostic importance of PNI and HRR on metastatic colorectal cancer survival. Patients and Methods: We retrospectively reviewed all patients diagnosed metastatic colorectal cancer. PNI is calculated as (serum albumin (g/L) +5*total lymphocyte count (109/L)). And HRR was calculated as the ratio of hemoglobin (g/dL) and RDW (%). We divided patients into two groups as PNI low and high. And we compared these two groups according to general characteristics and overall survival. We performed another comparision between HRR low and high. Results: We reviewed 346 metastatic colorectal cancer patients and we included 145 of them to the study. Univariate analysis revealed that presence of initially metastatic disease, right located tumor, low HRR, low PNI were correlated with poor overall survival. In multivariate analysis, presence of initially metastatic disease and low PNI remain statistcally significant according to poor survival. The median overall survival was statistically longer in HRR and PNI low groups than high groups. Conclusion: Both PNI and HRR are associated with poor overall survival in metastatic colorectal cancer

Keywords:

: Colon cancer, prognostic nutritional index, hemoglobin red cell distribution width ratio.,

PDF

___

Xia C, Dong X, Li H, et al. Cancer statistics in China and United States, 2022: profiles, trends, and determinants. Chin Med J (Engl). 2022;135(5):584-590.
Heinemann V, von Weikersthal LF, Decker T, et al. FOLFIRI plus cetuximab versus FOLFIRI plus bevacizumab as first-line treatment for patients with metastatic colorectal cancer (FIRE-3): a randomised, open-label, phase 3 trial. Lancet Oncol. 2014;15(10):1065-1075.
Koncina E, Haan S, Rauh S, Letellier E. Prognostic and predictive molecular biomarkers for colorectal cancer: updates and challenges. Cancers (Basel). 2020;12(2):319.
Silva NCD, Prestes IV, Gontijo WA, Pena GDG. High red blood cell distribution width is associated with a risk of short-term mortality in hospitalized surgical, but not clinical patients. Clin Nutr ESPEN. 2020;39:150-156.
Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell. 2010;140(6):883-899.
Zhang K, Qin W, Zheng Y, et al. Malnutrition contributes to low lymphocyte count in early-stage coronavirus disease-2019. Front Nutr. 2022;8:739216.
Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature. Nutr J. 2010;9:69.
Feng Z, Wen H, Ju X, et al. The preoperative prognostic nutritional index is a predictive and prognostic factor of high-grade serous ovarian cancer. BMC Cancer. 2018;18(1):883.
Kayikcioglu E, Iscan G. A novel prognostic index for metastatic colon cancer: the prognostic immune nutritional index. Cureus. 2023;15(1):e33808.
Qi Q, Song Q, Cheng Y, Wang N. Prognostic significance of preoperative prognostic nutritional index for overall survival and postoperative complications in esophageal cancer patients. Cancer Manag Res. 2021;13:8585-8597.
Tuncel ET, Parvizi M, Kut E, Aydın M, Kasap E. Prognostic significance of hemoglobin/prognostic nutritional index and hemoglobin/red blood cell distribution in rectal cancer. Turk J Gastroenterol. 2023;34(2):128-134.
Hong C, Wei Y, Jiang J, et al. Associations between lifestyles and neutrophil-lymphocyte and platelet-lymphocyte ratios in colorectal cancer. Asia Pac J Clin Oncol. 2014;10(2):168-174.
Luvián-Morales J, González-Trejo S, Carrillo JF, et al. Association of the prognostic nutritional index and overall survival in patients with colorectal cancer: a STROBE compliant retrospective cohort study. Cancer Med. 2019;8(7):3379-3388.
Polański J, Chabowski M, Świątoniowska-Lonc N, et al. Relationship between nutritional status and clinical outcome in patients treated for lung cancer. Nutrients. 2021;13(10):3332.
Fearon KC, Falconer JS, Slater C, McMillan DC, Ross JA, Preston T. Albumin synthesis rates are not decreased in hypoalbuminemic cachectic cancer patients with an ongoing acute-phase protein response. Ann Surg. 1998;227(2):249-254.
Canna K, McArdle PA, McMillan DC, et al. The relationship between tumour T-lymphocyte infiltration, the systemic inflammatory response and survival in patients undergoing curative resection for colorectal cancer. Br J Cancer. 2005;92(4):651-654.
Takamizawa Y, Shida D, Boku N, et al. Nutritional and inflammatory measures predict survival of patients with stage IV colorectal cancer. BMC Cancer. 2020;20(1):1092.
Siddiqui AD, Piperdi B. KRAS mutation in colon cancer: a marker of resistance to EGFR-I therapy. Ann Surg Oncol. 2010;17(4):1168-1176.
Wang PF, Song SY, Guo H, Wang TJ, Liu N, Yan CX. Prognostic role of pretreatment red blood cell distribution width in patients with cancer: a meta-analysis of 49 studies. J Cancer. 2019;10(18):4305-4317.
Wang PF, Song SY, Guo H, Wang TJ, Liu N, Yan CX. Prognostic role of pretreatment red blood cell distribution width in patients with cancer: A meta-analysis of 49 studies. J Cancer. 2019;10(18):4305-4317.
Rahamim E, Zwas DR, Keren A, et al. The ratio of hemoglobin to red cell distribution width: a strong predictor of clinical outcome in patients with heart failure. J Clin Med. 2022;11(3):886.