Significance of Naples prognostic score for postoperative complications after colorectal cancer surgery.

Purpose: The Naples prognostic score (NPS) is a sensitive scoring system that reflects both inflammatory and nutritional status. This study examined the significance of NPS in predicting postoperative complications following colorectal cancer surgery.

Methods: The present study included data from 443 patients who underwent curative resection for colorectal cancer. The patients were classified into low NPS (score 0-2) and high NPS (score 3-4) groups. We retrospectively investigated the relationship between NPS and postoperative complications (Clavien-Dindo classification ≥ II).

Results: Among all patients, 57 (13%) developed postoperative complications. A total of 340 patients (77%) were categorized into the low NPS group and 103 (23%) were categorized into the high NPS group. A multivariate analysis identified that high NPS (P < 0.001), tumor location in the rectum (P = 0.025), longer operation time (P = 0.027), and greater blood loss (P = 0.004) were independent risk factors for postoperative complications. Furthermore, high NPS was significantly associated with older age (P < 0.001), higher American Society of Anesthesiologists physical status score (P = 0.029), advanced T stage (P < 0.001), N stage (P = 0.036), and longer length of hospital stay (P < 0.010).

Conclusions: NPS is a strong predictor of poor outcomes in patients undergoing curative resection for colorectal cancer, suggesting the importance of systemic inflammation and the nutritional status.