Development and validation of a novel strong prognostic index for colon cancer through a robust combination of laboratory features for systemic inflammation: a prognostic immune nutritional index

Sang Hyuk Jung, Jie Hao, Manu Shivakumar, Yonghyun Nam, Jaesik Kim, Min Jung Kim, Seung Bum Ryoo, Eun Kyung Choe, Seung Yong Jeong, Kyu Joo Park, Sung Chan Park, Dae Kyung Sohn, Jae Hwan Oh, Hong Hee Won, Dokyoon Kim, Ji Won Park

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Systemic inflammation is associated with survival outcomes in colon cancer. However, it is not well-known which systemic inflammatory marker is a powerful prognostic marker in patients with colon cancer. Methods: A total of 4535 colon cancer patients were included in this study. We developed a novel prognostic index using a robust combination of seven systemic inflammation-associated blood features of the discovery set. The predictability and generality of the novel prognostic index were evaluated in the discovery, validation and replication sets. Results: Among all combinations, the combination of albumin and monocyte count was the best candidate expression. The final formula of the proposed novel index is named the Prognostic Immune and Nutritional Index (PINI). The concordance index of PINI for overall and progression-free survival was the highest in the discovery, validation and replication sets compared to existing prognostic inflammatory markers. PINI was found to be a significant independent prognostic factor for both overall and progression-free survival. Conclusions: PINI is a novel prognostic index that has improved discriminatory power in colon cancer patients and appears to be superior to existing prognostic inflammatory markers. PINI can be utilised for decision-making regarding personalised treatment as the complement of the TNM staging system.

Original languageEnglish
Pages (from-to)1539-1547
Number of pages9
JournalBritish Journal of Cancer
Volume126
Issue number11
DOIs
StatePublished - 1 Jun 2022

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