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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gastrointestinal Cancers: Colorectal Cancer
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1446557

Aminotransferase-to-lymphocyte ratio as a valuable prognostic marker for patients with stage I-III colorectal cancer: A Retrospective Study

Provisionally accepted
Hailun Xie Hailun Xie Wei Lishuang Wei Lishuang Shuangyi Tang Shuangyi Tang Jialiang Gan Jialiang Gan *
  • Department of Colorectal Anal Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, China

The final, formatted version of the article will be published soon.

    Background: There are no population-based studies on the prognostic value of the preoperative aminotransferase-to-lymphocyte ratio (AALR) in predicting recurrence and survival in patients with colorectal cancer (CRC) who have undergone curative resection.Aim: This study explored the relationship between AALR and prognosis of CRC patients, specifically stage III CRC.Restricted Cubic Splines were used to evaluate the relationship between AALR and outcomes. The survival curve was generated using the Kaplan-Meier method and the log-rank test. COX regression analysis was used to identify the independent prognostic factors of CRC patients. Logistic regression analysis was used to assess the independent risk factors affecting sarcopenia and postoperative complications. Concordance index and calibration curves were used to evaluate the discriminative ability of the prognostic nomograms. Finally, according to a ratio of 7:3, the total population was randomized into two cohorts to validate the practicability of the prognostic nomograms.In total, 1304 stage I-III CRC were enrolled in this study. There was a significant positive correlation between AALR and PFS/OS in CRC patients. The PFS/OS ratio of the high AALR group was significantly lower than that of the low AALR group. In the subgroup analysis, we found that the AALR significantly stratified the prognosis of patients with stage III CRC. A high AALR was still independently associated with poor PFS (HR = 1.335, 95% CI =1.075-1.657, p=0.009) and OS (HR = 1.382, 95% CI =1.139-1.677, p=0.001) in CRC patients. Variables with a value ≤ 0.05 in multivariable analysis were incorporated into the construction of prognostic nomograms for predicting 1-5 years PFS/OS of CRC patients. The results of the concordance index and calibration curves confirmed that these prognostic nomograms had a good prediction accuracy. In addition, we demonstrated the good predictive performance of these nomograms in a randomized internal validation cohort.AALR is an effective prognostic marker for predicting long-term outcomes and could provide a valuable reference for sarcopenia and postoperative complications in CRC patients. AALRbased nomograms have good predictive accuracy and can help to develop individualized risk stratification, follow-up, and treatment strategies for CRC patients.

    Keywords: Prognostic nomograms, aminotransferase-to-lymphocyte ratio, colorectal cancer, Survival, Sarcopenia, Postoperative Complications

    Received: 10 Jun 2024; Accepted: 31 Oct 2024.

    Copyright: © 2024 Xie, Lishuang, Tang and Gan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jialiang Gan, Department of Colorectal Anal Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.