ArticleFrontiers in oncology2026
Serial assessment of inflammatory biomarkers as a prognostic factor for first-line treatment outcomes in patients with metastatic colorectal cancer: single-center retrospective study.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Metastatic colorectal cancer (mCRC) is a major cause of cancer-related mortality, with limited curative options despite advances in targeted therapies. Reliable prognostic biomarkers are needed to guide treatment. Inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) may predict poor outcomes. This study evaluated the prognostic value of serial NLR and SII assessments in first-line mCRC therapy. Methods: In this single-center, retrospective, observational study, we obtained data on 258 patients who started first-line systemic chemotherapy from the beginning of 2016 until the end of 2018. Baseline (pretreatment) and 3-month post-treatment values of NLR and SII were used to determine their prognostic value for treatment outcomes, which were measured as progression-free survival (PFS) and overall survival (OS). Results: Patients were divided by pretreatment median NLR (3.19) and SII (810). Low NLR was associated with longer PFS (15.4 vs. 9.5 months, p=0.031) and OS (39.1 vs. 27.2 months, p=0.002). After 3 months, PFS difference increased (14.3 vs. 4.5 months, p<0.001); OS was longer but not significantly (35.3 vs. 20.1 months, p=0.14). Low SII after three months of therapy was linked to improved PFS (14.1 vs. 6.8 months, p<0.001) and OS (36.4 vs. 21.6 months, p=0.001), while at baseline assessment it was associated with longer OS (39.4 vs. 27.1 months, p=0.003), but not with PFS (13.9 vs. 10.6 months, p=0.11). Multivariate analysis showed pretreatment NLR and SII were independent prognostic factors for OS, but not PFS. Post-treatment NLR was prognostic for PFS only, while post-treatment SII was prognostic for both OS and PFS. Conclusions: Serial evaluation of NLR and SII could identify patients who are at increased risk of poor survival outcomes.
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