A Novel Nutrition-Related Prognostic Biomarker for Predicting Survival in Patients with Colorectal Cancer.

Background: Colorectal cancer (CRC) is a prevalent global malignancy with substantial morbidity and mortality. Accurate prognostic evaluation is essential in CRC patient management. This study investigates the prognostic significance of red blood cell count (RBC) and Onodera's prognostic nutritional index (OPNI) in resectable CRC patients. Methods: A retrospective analysis of 210 CRC patients undergoing radical resection (January 2015–January 2017) assessed clinical and hematological factors, including RBC, albumin, hemoglobin, and OPNI. A novel comprehensive biomarker, R-OPNI, combining preoperative RBC with OPNI, was introduced. Correlations with patient survival were analyzed, and R-OPNI's independent prognostic value was assessed through univariate and multivariate Cox models. Predictive ability was compared to other factors using the receiver operating characteristic (ROC) method. Results: Higher RBC levels (≥ 3.9 × 1012/L) and elevated OPNI were associated with significantly improved overall survival. Lower R-OPNI scores (0 or 1) indicated notably poorer survival. Multivariate analysis confirmed R-OPNI's independent prognostic significance (HR: 0.273, 95% CI: 0.098–0.763, p = 0.013). R-OPNI (AUC = 0.732) demonstrated superior predictive value compared to individual prognostic factors. Conclusion: R-OPNI emerges as a robust, independent prognostic predictor for resectable CRC patients, emphasizing the importance of assessing preoperative nutritional status. [ABSTRACT FROM AUTHOR]