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. 2025 Oct 25;9(4):437-446.
doi: 10.23922/jarc.2024-103. eCollection 2025.

The Preoperative C-reactive Protein/Albumin Ratio of Immune-inflammation Index Is an Independent Prognostic Factor of Advanced Colorectal Cancer in Older Patients (≥ 65 years)

Naohiro Yoshida  1 , Haruki Yonemori  1 , Yoshiki Miyamoto  1 , Ai Nishihira  1 , Takahiro Shigaki  1 , Kenji Fujiyoshi  1 , Kenichi Koushi  1 , Takefumi Yoshida  1 , Tomoya Sudo  1 , Toru Hisaka  1 , Nobuya Ishibashi  1 , Fumihiko Fujita  1
Affiliations

The Preoperative C-reactive Protein/Albumin Ratio of Immune-inflammation Index Is an Independent Prognostic Factor of Advanced Colorectal Cancer in Older Patients (≥ 65 years)

Naohiro Yoshida et al. J Anus Rectum Colon. .

Abstract

Objectives: We investigated the characteristics of colorectal cancer (CRC) in older patients (≥ 65 years) and the immune-inflammation indexes.

Methods: This study included 149 patients aged ≥ 65 years with advanced colorectal cancer, who underwent radical surgery (R0 resection). Four immune-inflammation indexes (C-reactive protein-to-albumin ratio (CAR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and neutrophil-to-lymphocyte ratio (NLR)) were calculated. We analyzed the association between immune-inflammation indexes and clinicopathological features or prognosis.

Results: Tumor depth and lymph node metastasis were independent prognostic factors for recurrence-free survival (RFS) in multivariate analysis (p=0.03, hazard ratio [HR] 2.095, 95% confidence interval (CI) 1.225-3.982 and p=0.008, HR 2.209, 95% CI 1.225-3.982, respectively). Lymphatic invasion and CAR were also independent prognostic factors for overall survival (OS) in multivariate analysis (p=0.04, HR 2.197, 95% CI 1.042-4.632 and p=0.04, HR 2.174, 95% CI 1.032-4.58, respectively). Lymphatic invasion and CAR were independent prognostic factors for cancer specific survival (CSS) in the multivariate analysis (p=0.03, HR 3.004, 95% CI 1.11-8.13 and p=0.03, HR 3.087, 95% CI 1.135-8.394, respectively).

Conclusions: CAR is a useful immune-inflammation index for predicting the prognosis after radical resection for advanced CRC in older patients.

Keywords: CAR; colorectal cancer; immune-inflammation index; older patients.

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Conflict of interest statement

Conflicts of Interest There are no conflicts of interest.

Figures

Figure 1.
Figure 1.
Kaplan-Meier curves for recurrence free survival, overall survival, and cancer specific survival according to CAR.
See this image and copyright information in PMC

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