Prognostic significance of prognostic nutritional index and hemoglobin to red cell distribution width ratio in metastatic colorectal cancer patients

Abstract

Aims: Malnutrition and systemic inflammation are poor prognostic factors in cancer. Prognostic nutritional index (PNI) and Hemoglobin to red blood cell distribution witdh (HRR) are considired indicators of malnutrition and systemic inflammation. We aimed to investigate the prognostic importance of PNI and HRR on metastatic colorectal cancer survival. Patients and Methods: We retrospectively reviewed all patients diagnosed metastatic colorectal cancer. PNI is calculated as (serum albumin (g/L) +5*total lymphocyte count (109/L)). And HRR was calculated as the ratio of hemoglobin (g/dL) and RDW (%). We divided patients into two groups as PNI low and high. And we compared these two groups according to general characteristics and overall survival. We performed another comparision between HRR low and high. Results: We reviewed 346 metastatic colorectal cancer patients and we included 145 of them to the study. Univariate analysis revealed that presence of initially metastatic disease, right located tumor, low HRR, low PNI were correlated with poor overall survival. In multivariate analysis, presence of initially metastatic disease and low PNI remain statistcally significant according to poor survival. The median overall survival was statistically longer in HRR and PNI low groups than high groups. Conclusion: Both PNI and HRR are associated with poor overall survival in metastatic colorectal cancer