Prognostic significance of preoperative prognostic immune and nutritional index in patients with stage I–III colorectal cancer

Abstract

Background: To explore the value of preoperative prognostic immune and nutritional index (PINI) in predicting postoperative complications and long-term outcomes in patients with stage I–III colorectal cancer (CRC). Methods: Restricted cubic splines were used to assess the relationship between PINI and survival in patients with CRC. The Kaplan–Meier method and log-rank test were used to plot the survival curves. The Cox proportional hazards model was used to evaluate independent prognostic predictors in patients with CRC. A logistic regression analysis was performed to identify independent predictors of postoperative complications. The least absolute shrinkage and selection operator (LASSO) logistic regression algorithm was used for feature screening. Results: An evident positive dose–response relationship between PINI and survival in patients with CRC was identified. Compared with patients with a high PINI, those with a low PINI had worse disease-free survival (DFS) (47.9% vs. 66.9%, p < 0.001) and overall survival (OS) (49.7% vs. 70.2%, p < 0.001). The Cox proportional hazards model revealed that PINI was independently associated with DFS (hazard ratio [HR], 0.823; 95% confidence interval [CI], 0.754–0.898; p < 0.001) and OS (HR, 0.833; 95% CI, 0.761–0.912; p < 0.001) in patients with CRC. In the logistic regression analysis, PINI was an independent factor affecting postoperative complications in patients with CRC (odds ratio, 0.710; 95%CI: 0.610–0.810, p < 0.001). The LASSO logistic regression algorithm was used to screen for effective prognostic variables. Finally, we constructed PINI-based nomograms to predict postoperative 1–5-year PFS, and OS in patients with CRC. Conclusion: PINI is an effective biomarker for predicting postoperative complications, DFS, and OS in patients with stage I–III CRC.