Prognostic value of systemic inflammatory and nutritional markers in patients with resectable colon cancer: a retrospective observational study

Background: Colorectal cancer remains a leading cause of global cancer morbidity.While pathological staging is a cornerstone of prognosis, host-related factors, including systemic inflammatory response and nutritional status, are increasingly recognized as critical determinants of outcomes.Methods: This single-center retrospective study investigated the prognostic value of preoperative hematologic markers -neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index, C-reactive protein-to-albumin ratio, prognostic nutritional index (PNI), and the Controlling Nutritional Status score -in 113 patients who underwent radical colectomy between December 2020 and June 2022.The primary and secondary endpoints were 3-year disease-free survival (DFS) and overall survival (OS), respectively.Results: The cohort demonstrated 3-year DFS and OS rates of 74.1% and 77.0%, respectively, and an overall recurrence rate of 23.9% within the follow-up period.Multivariate Cox analysis identified a high PNI (≥ 43.62) as an independent protective factor for 3-year DFS (hazard ratio [HR] = 0.057, 95% confidence interval [CI]: 0.016-0.125,P < 0.01), and a high PLR (≥ 169.27) as an independent risk factor (HR = 7.910, 95% CI: 2.048-30.558,P < 0.01).Conclusion: Preoperative PNI and PLR are readily accessible, independent prognostic biomarkers for patients with resectable colon cancer.They augment traditional Tumor, Node, Metastasis staging by reflecting the critical balance between pro-tumor inflammation and host immunonutritional status within the tumor microenvironment.