Impact of New Inflammation/Nutrition-Based Indicators on Prognosis in Elderly Patients With Colorectal Cancer

This study aimed to investigate the impact of new inflammation/nutrition-based indicators-the modified cachexia index (mCXI) on the prognosis of elderly patients with colorectal cancer and develop a nomogram model.

A retrospective analysis was conducted using clinical data from patients over 70 years old diagnosed with colorectal cancer, at the Affiliated Hospital of Qingdao University between July 2018 and December 2023. Univariate and multivariate Cox regression analyses, based on overall survival (OS) and recurrence-free survival (RFS), identified independent prognostic factors. A nomogram prediction model was constructed using multivariate analysis.

The study included 456 patients, comprising 273 males (59.9%) and 183 females (40.1%), with a mean age of 75 years. The median follow-up was 41 months. The 1-, 3-, and 5-year OS rates were 85%, 65%, and 50%, respectively, while the 1-, 3-, and 5-year RFS rates were 80%, 55%, and 40%, respectively. Multivariate Cox regression identified age, tumor T stage, tumor N stage, and mCXI as independent factors affecting both OS and RFS. A nomogram prognostic model was developed, with area under the ROC curve (AUC) values of 0.742, 0.809, and 0.799 for 1-, 3-, and 5-year OS, respectively, and AUC values of 0.769, 0.798, and 0.797 for 1-, 3-, and 5-year RFS, respectively. Calibration curves indicated strong agreement with the ideal model and decision curve analysis confirmed the model's robust predictive accuracy.

The mCXI serves as an independent risk factor for both RFS and OS in elderly patients with colorectal cancer. The nomogram prediction model demonstrates strong prognostic value for this patient group.