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Updated: May 24, 2025

Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Pan‑immune‑inflammatory values predict survival in patients after radical surgery for non‑metastatic colorectal
Kejin Li1, Xiangyue Zeng1, Ziyi Zhang1
1Department of Gastrointestinal Surgery, The Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region 830000, P.R. China.
Abstract:
The present study aimed to further investigate the predictive value of pan-immune-inflammatory values (PIVs) in patients with non-metastatic colorectal cancer after radical surgery. Additionally, the study sought to develop a predictive scoring model to predict the survival of patients with colorectal cancer after surgery. A total of 470 non-metastatic patients who attended The Affiliated Cancer Hospital of Xinjiang Medical University (Urumqi, China) for radical colorectal cancer surgery were retrospectively collected based on specific inclusion and exclusion criteria. Patients were categorized into the Low-PIV group and the High-PIV group according to the optimal cut-off value of PIV and a survival analysis was performed. Cox regression was performed for one-way multifactorial analysis. After independent risk factors were screened, a simple score prediction model was constructed and evaluated. The study indicated that PIV was significantly associated with the T stage, Tumor-Node-Metastasis stage, differentiated degree and nerve invasion (all P<0.05). Survival tanalysis showed that patients in the Low-PIV group had a significantly higher 5-year overall survival (OS) rate compared with those in the High-PIV group (88.7 vs. 46.3%; P<0.001). Through multifactorial Cox regression analysis, N stage [hazard ratio (HR), 2.00; 95% confidence interval (CI), 1.04-3.84; P=0.039], differentiated degree (HR, 1.98; 95% CI, 1.16-3.38; P=0.012), neutrophil/lymphocyte ratio (HR, 4.00; 95% CI, 2.19-7.29; P<0.001) and PIV (HR, 4.12; 95% CI, 2.04-8.32; P<0.001) were found to be independent predictors of OS. These variables were included in a column chart to create a scoring system. The concordance index was 0.789 (95% CI, 0.746-0.832). The 1-, 3- and 5-year calibration curves for this column-line diagram demonstrated high confidence. The area under the curve of the predictive model for 1-, 3- and 5-year OS were 0.823, 0.845 and 0.845, respectively. PIV was shown to be a reliable biomarker for the prognosis of patients with non-metastatic colorectal cancer. The current simple predictive scoring model can predict the effective survival of patients following radical surgery for non-metastatic colorectal cancer and could therefore play a substantial role in clinical decision-making.
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