Ann Surg Treat Res.  2024 Mar;106(3):169-177. 10.4174/astr.2024.106.3.169.

Effect of preoperative pan-immune-inflammation value on clinical and oncologic outcomes after colorectal cancer surgery: a retrospective study

• Seo YJ
• Kim KE
• Jeong WK
• Baek SK
• Bae SU

• KMID: 2553387
• DOI: http://doi.org/10.4174/astr.2024.106.3.169

Abstract

Purpose
Surgical resection, the primary treatment for colorectal cancer (CRC), is often linked with postoperative complications that adversely affect the overall survival rates (OS). The pan-immune-inflammation value (PIV), a novel biomarker, is promising in evaluating cancer prognoses. We aimed to explore the impact of preoperative immune inflammation status on postoperative and long-term oncological outcomes in patients with CRC.
Methods
A retrospective analysis of 203 patients with CRC who underwent surgery (January 2016–June 2020) was conducted. The preoperative PIV was calculated as [(neutrophil count + platelet count + monocyte count) / lymphocyte counts]. The PIV optimal cutoff value was determined based on the OS using the Contal and O’Quigley methods.
Results
A PIV value ≥155.90 was defined as high. Patients were categorized into low-PIV (n = 85) and high-PIV (n = 118) groups. Perioperative clinical outcomes (total operation time, time to gas out, sips of water, soft diet, and hospital stay) were not significantly different between the groups. The high-PIV group exhibited more postoperative complications (P = 0.024), and larger tumor size compared with the low-PIV group. Multivariate analysis identified that American Society of Anesthesiologists grade III (P = 0.046) and high-PIV (P = 0.049) were significantly associated with postoperative complications. The low-PIV group demonstrated higher OS (P = 0.001) and disease-free survival rates (DFS) (P = 0.021) compared with the high-PIV group. Advanced N stage (P = 0.005) and high-PIV levels (P = 0.047) were the identified independent prognostic factors for OS, whereas advanced N stage (P = 0.045) was an independent prognostic factor for DFS.
Conclusion
Elevated preoperative PIV was associated with an increased incidence of postoperative complications and served as an independent prognostic factor for OS.

Keyword

Colorectal neoplasms; Inflammation; Immune system; Postoperative complication; Survival

Figure

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  Fig. 1 Flow chart of the exclusion criteria. CRC, colorectal cancer; CBC, complete blood count; PIV, pan-immune-inflammation index.

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  Fig. 2 The Kaplan-Meier survival curve for the overall survival and disease-free survival. PIV, pan-immune-inflammation index.

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