Prognostic Significance of Preoperative Fibrinogen-to-Prealbumin Ratio in Patients with Stage I-III Colorectal Cancer Undergoing Surgical Resection: A Retrospective Cohort Study.

ABSTRACT

BACKGROUND: The objective of this study was to explore the role of preoperative fibrinogen-to-prealbumin ratio (FPR) in evaluating the prognosis of patients with stage I-III colorectal cancer (CRC). METHODS: This retrospective study enrolled 584 stage I-III CRC patients undergoing surgical resection. Logistic regression analysis was used to explore the correlation between FPR and postoperative complications. The Kaplan-Meier curve and Cox proportional hazards model were used to identify the prognostic factors. The nomograms were constructed based on the prognostic factors. The concordance index and calibration curve were used to determine the accuracy of the nomograms. Time-dependent receiver operating characteristic was used to compare the predictive prognostic efficacy of nomograms and TNM stage. RESULTS: FPR was determined to be an independent factor affecting postoperative complications. Patients with a low-FPR had a significantly better prognosis than those with a high-FPR (disease-free survival, p = 0.028; overall survival, p = 0.027), especially patients with stage I CRC (disease-free survival, p = 0.015; overall survival, p = 0.017). The Cox proportional hazards model identified FPR as an independent poor prognostic factor of disease-free survival (hazard ratio (HR) = 1.459, 95% confidence interval (CI) = 1.074-1.954, p = 0.011) and overall survival (HR = 1.405, 95% CI = 1.034-1.909, p = 0.030). The prognostic nomograms had good accuracy and were superior to the traditional TNM stage. CONCLUSIONS: FPR is a potential indicator for predicting short- and long-term prognosis of stage I-III CRC patients undergoing surgical resection.