Integrating nutritional and immune-inflammation-based index predicts disease-free survival of colorectal cancer patients undergoing radical surgery

Background: of survival outcomes in various tumors. The study aimed to investigate the prognostic superiority of an integrated scoring system for long-term disease-free survival (DFS) in hospitalized patients with colorectal cancer (CRC). Methods: A review of 1,443 patients undergoing radical surgery for CRC was conducted. The prognostic nutritional index (PNI), systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) were identified and utilized to develop the integrated nutritional-inflammatory-immunological scores: the nutritional-systemic immune inflammation (N-SII) and nutritional-systemic inflammation response (N-SIRI) indices. Primary endpoint was the predictive power for survival determined by the area under the curve (AUC) using receiver operating characteristic analysis. Secondary outcomes included optimal cut-off values, hazard ratios (HRs) and the prediction of long-term DFS after discharge. Results: 43.95 (42.58-45.33), P<0.001 for N-SIRI] compared to low-risk patients. Conclusions: The integrated scores of N-SII and N-SIRI complemented the limitation of each individual index, demonstrating superior accuracy in predicting long-term DFS in CRC patients.