Pre-Stenting Inflammatory Burden Index (IBI) as a Predictor of Survival and Postoperative Complications in Patients with Obstructive Colorectal Cancer.

Abstract

Objectives: Growing evidence suggests that cancer prognosis is influenced by the host's immune-inflammatory environment. The inflammatory burden index (IBI) is a newly established, potent inflammation-based marker easily calculated from laboratory findings. We evaluated the prognostic significance of IBI in patients with nonmetastatic obstructive colorectal cancer (OCRC) who underwent curative surgery following insertion of a self-expandable metallic stent as a bridge to curative surgery.

Methods: Eighty-six patients with pathological stages I-III OCRC were retrospectively analyzed to investigate the association between IBI and short- and long-term results.

Results: This study included 50 males and 36 females. The median age was 71.5 years, and the median follow-up time was 43 months. There were 34 postoperative complications, including 17 infectious complications. Sixty-three patients were classified as pre-stenting IBI-high using a cutoff of 0.9. Multivariate analyses revealed that high IBI was independently correlated with poorer disease-free survival (DFS) [hazard ratio (HR) = 4.10, 95% confidence interval (CI) 1.37-12.28, P = 0.012] and overall survival (OS) (HR = 9.32, 95% CI 1.15-75.63, P = 0.037). Moreover, patients with a high IBI had significantly more postoperative (P = 0.013) and infectious complications (P = 0.034). The preoperative IBI values had no prognostic significance.

Conclusions: A high pre-stenting IBI was independently associated with poor DFS and OS. Additionally, it serves as a robust predictor of postoperative and infectious complications. Given that IBI can be easily derived from routine laboratory tests, its clinical utility is readily applicable in daily practice.