Survival prediction in stage II/III rectal cancer: Role of immune-inflammatory biomarkers post neoadjuvant chemoradiotherapy.

The precise prediction of survival outcomes in rectal cancer is essential for the development of personalized treatment strategies, particularly due to the heterogeneity in patient prognosis and response to therapy. The present study examined the prognostic significance of immune-inflammatory markers, in predicting outcomes of patients with stage II and III rectal cancer undergoing neoadjuvant chemoradiotherapy (NCRT). The present retrospective cohort analysis included 651 patients diagnosed with stage II/III rectal cancer, all of whom underwent NCRT as part of their treatment regimen. Data relative to clinical and pathological variables, including carcinoembryonic antigen (CEA), neutrophil count, lymphocyte count, eosinophil count and the neutrophil-to-lymphocyte ratio (NLR) were collected and examined. These variables were subjected to multivariate Cox regression analysis to independently predict overall survival (OS) and disease-free survival (DFS). Furthermore, prognostic nomograms were constructed and validated to enhance the prediction of patient outcomes. CEA, neutrophil count, lymphocyte count, eosinophil count and the NLR were determined to be independent predictors of OS and DFS in Cox regression analyses. A nomogram was constructed to incorporate these five prognostic biomarkers, which demonstrated good calibration and accurately predicted outcomes, with close agreement between the predicted and observed results. Notably, elevated post-NCRT NLR was significantly associated with poorer survival. In conclusion, the present study constructed and validated a prognostic model to predict OS and DFS in patients with stage II/III rectal cancer receiving NCRT, based on readily accessible clinical biomarkers. This model may have potential clinical utility for prognosis.