Analysis of prognostic factors for survival in patients with cancer of the left colon including data from calculated hematological indices

Introduction. Indices calculated from complete blood count parameters are actively investigated as prognostic factors in patients with colorectal cancer, although their role remains incompletely understood.

Methods. A retrospective analysis was performed on 187 patients with colon and rectal cancer (stages I–III) who underwent radical surgical treatment between 2019 and 2023. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), Systemic Immune-Inflammation Index (SII) before surgery and on postoperative days 1, 3, and 5 were assessed, along with postoperative complications (Clavien–Dindo), overall and disease-free survival, and their association with the studied prognostic indices.

Objective. To evaluate the prognostic significance of clinical, morphological and hematological data for key clinical outcomes in patients undergoing radical resection for colorectal cancer.

Results. Three-year overall survival was 85.6 %, and three-year disease-free survival was 78.7 %. Multivariate analysis revealed that none of the hematological indices were independent prognostic factors for overall or disease-free survival. The prognostic factors for overall survival were coronary artery disease (HR 5.176; 95 % CI 1.105–24.246; p=0.037) and pN+ (HR 3.073; 95 % CI 1.251–7.545; p=0.014). The prognostic factors for disease-free survival were female sex (HR 0.019; 95 % CI 0.001–0.451; p=0.014) and CEA level (HR 1.116; 95 % CI 1.022–1.218; p=0.014).

Conclusion. The hematological prognostic indices studied did not demonstrate independent prognostic significance for the risk of postoperative complications or survival in colorectal cancer after radical surgery and may only be considered as part of a comprehensive assessment.

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