Related Experiment Video
Updated: May 9, 2026
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Association between 12 composite inflammatory indices and postoperative complications in colorectal cancer surgery: a
Chunpeng Pan1, Jiwei Yu1, Shuai Huang2
1Department of General Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Background:
Postoperative complications (POCs) remain a major challenge in colorectal cancer (CRC) surgery. Easily accessible composite inflammatory indices derived from routine blood tests hold promise for preoperative risk stratification, but their comparative predictive value for POCs is unclear.
Methods:
We conducted a two-center, retrospective study of 1331 patients who underwent radical CRC surgery between January 2021 to October 2025. The associations between preoperative composite inflammatory indices and the complications after surgery were evaluated using logistic regression. Their predictive discriminative performances were further assessed and compared using receiver operating characteristic (ROC) curve analysis, with the areas under the curve (AUC) compared by DeLong's test.
Results:
The complication rate was 17.2% (229/1331). Patients with complications exhibited a significantly more pronounced pro-inflammatory and immunosuppressive preoperative profile across all indices (all P < 0.05). After adjustment, the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), C-reactive protein-to-lymphocyte ratio (CLR), and systemic inflammation response index (SIRI) were identified as the strongest independent predictors, with the highest quartile (Q4) conferring substantially increased risks (OR for SII: 7.51; for NLR: 5.86; for CLR: 2.24; for SIRI: 2.99; all P-trend <0.05). ROC analysis confirmed SII as the best single predictor (AUC: 0.738). A combined model integrating SII, NLR, CLR, and SIRI achieved superior discriminative ability (AUC: 0.792), significantly outperforming any single index (all P < 0.05).
Conclusion:
The SII, NLR, CLR and SIRI, are strongly associated with the risk of POCs after CRC surgery. A model combining these four indices provides superior predictive performance.
Related Concept Videos
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:20Inflammatory Bowel Disease II: Ulcerative Colitis
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...