Prognostic value of routine blood biomarkers in 3-year survival of resectable colorectal cancer patients: a prognostic nomogram for clinical practice

David Moro-Valdezate ^1,2, José Martín-Arévalo ^3,4, Coral Cózar-Lozano ⁵

¹Department of Surgery, University of Valencia, Av. Blasco Ibáñez, 17, 46010, Valencia, Spain. david.moro@uv.es.
²Colorectal Surgery Unit, Department of General and Digestive Surgery, INCLIVA Biomedical Research Institute, Hospital Clínico Universitario de Valencia, Av. Blasco Ibáñez, 17, 46010, Valencia, Spain. david.moro@uv.es.
³Department of Surgery, University of Valencia, Av. Blasco Ibáñez, 17, 46010, Valencia, Spain. martin_jose@gva.es.
⁴Colorectal Surgery Unit, Department of General and Digestive Surgery, INCLIVA Biomedical Research Institute, Hospital Clínico Universitario de Valencia, Av. Blasco Ibáñez, 17, 46010, Valencia, Spain. martin_jose@gva.es.
⁵Colorectal Surgery Unit, Department of General and Digestive Surgery, INCLIVA Biomedical Research Institute, Hospital Clínico Universitario de Valencia, Av. Blasco Ibáñez, 17, 46010, Valencia, Spain.
⁶Department of Surgery, University of Valencia, Av. Blasco Ibáñez, 17, 46010, Valencia, Spain.
⁷Department of Pathology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia. CIBERONC, Instituto de Salud Carlos III, Madrid, Spain.
⁸Department of Medical Oncology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia. CIBERONC, Instituto de Salud Carlos III, Madrid, Spain.

⁰Department of Surgery, University of Valencia, Av. Blasco Ibáñez, 17, 46010, Valencia, Spain. david.moro@uv.es.

International Journal of Colorectal Disease +

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March 5, 2025

View abstract on PubMed

Summary

This study developed a prognostic model for colorectal cancer (CRC) using routine blood biomarkers and clinical data to predict survival outcomes. The model effectively stratifies risk, aiding in preoperative patient assessment for curative surgery.

Area Of Science

Oncology
Biomarkers
Surgical Oncology

Background

Colorectal cancer (CRC) prognosis is complex, influenced by clinical factors and patient characteristics.
Identifying reliable preoperative predictors of survival is crucial for effective treatment planning and patient management.

Purpose Of The Study

To develop a prognostic model for colorectal cancer (CRC) patients.
To integrate routine preoperative peripheral blood biomarkers with clinical factors for enhanced predictive accuracy.
To predict 3-year cancer-specific survival (CSS) and disease-free survival (DFS) in CRC patients undergoing curative surgery.

Main Methods

Observational study of 764 CRC patients (Stages I-III) undergoing curative surgery.
Analysis of demographic, tumor, and preoperative immune/inflammatory markers.
Development and validation of Cox regression models and nomograms using split-sample approach, with ROC curve analysis for survival prediction.

Main Results

Independent predictors for 3-year DFS included laparoscopic surgery, prognostic nutritional index (PNI), neutrophil count, lymphocyte count, and Charlson comorbidity index.
Independent predictors for 3-year CSS included age, systemic immune-inflammation index (SII), serum albumin, and platelet count.
The CSS model, significantly influenced by SII and platelet count, demonstrated robust predictive performance (AUCs ranging from 71% to 89.2%).

Conclusions

Routine preoperative inflammatory biomarkers and clinical parameters are strong predictors of 3-year survival in CRC patients.
Systemic inflammation plays a significant role in CRC prognosis.
The developed prognostic model supports preoperative risk stratification for patients undergoing curative resection.

Keywords:

Blood biomarkers Colorectal cancer Prognosis

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