| [Background] Chronic inflammation and malnutrition are critical causes in the initiation and progression of colorectal cancer (CRC). This study aimed to investigate the prognostic value of the preoperative fibrinogen-to-pre-albumin ratio index (FPRI) in CRC patients undergoing a radical primary tumor resection and compare it with the fibrinogen-to-albumin ratio index (FARI) and other systemic inflammation markers, including the neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR). [Methods] We analyzed preoperative FPRI, FARI, NLR, and PLR in 249 surgical CRC patients. Thresholds were determined using receiver operating characteristic (ROC) curve analysis, and their prognostic values for overall survival (OS) or disease-free-survival (DFS) were assessed using Kaplan-Meier curves and Cox regression models. We used a nomogram of several risk factors to evaluate survival risk, and Harrell’s concordance index (c-index) to predict the accuracy of estimation. [Results] Univariate analysis showed that FPRI (P<0.001), FARI (P<0.001), NLR (P=0.01), and PLR (P<0.001) were prognostic factors of CRC survival. FPRI in predicting OS and DFS were superior to FARI and other inflammatory markers (AUCFPRI: 0.618, AUCFARI:0.545、AUCNLR:0.511和AUCPLR:0.549). Multivariable analysis revealed that high FPRI (P<0.01), high PLR (P<0.01) and high COFP (combination of FPRI and PLR) (P<0.001) were significantly correlated with OS and DFS. Patients with high FPRI, PLR and COFP values experienced a significantly reduction in OS and DFS; Subgroup analysis showed that COFP had a better predictive value in patients with advanced CRC (P<0.001). Nomograms containing FPRI and PLR improved the predictive accuracy (C-indexes were 0.760 and 0.750, respectively). [Conclusions] Our findings demonstrated that FPRI or PLR might predict prognosis for CRC, but the combined use of the both (COFP) could act as a better independent prognostic biomarker of CRC than FPRI or PLR alone. |
