Survival Predictors in Obstructive Colorectal Cancer: A Combined Clinical, Inflammatory, and Histopathological Approach.

Abstract

Background/aim: Obstructive colorectal cancer (oCRC) accounts for a significant proportion of colorectal malignancies and is associated with poor prognosis and higher perioperative morbidity. Inflammation-based biomarkers have emerged as potential predictors of survival in various cancers. However, their prognostic role in oCRC remains unclear.

Patients and methods: This retrospective study included patients who underwent surgery for histopathologically confirmed oCRC at Sakarya University Training and Research Hospital between January 2015 and February 2024. Preoperative systemic inflammatory markers-C-reactive protein-to-albumin ratio (CAR), lymphocyte-to-C-reactive protein ratio (LCR), prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory index (SII), and HALP score-were analyzed. Overall survival was recorded, and statistical analyses were performed.

Results: Among the inflammatory markers, CAR, LCR, and PNI were significantly associated with overall survival at 1, 3, and 5 years (p <0.05). LCR demonstrated the highest sensitivity and specificity in predicting mortality. Patients with higher CAR and lower PNI values had significantly poorer outcomes.

Conclusion: Preoperative systemic inflammatory markers, particularly LCR, CAR, and PNI, are valuable prognostic indicators in patients with oCRC. These easily obtainable markers may help guide clinical decision-making and improve individualized patient management.