Evidence map›Paper›PMID 42840707›Full record

ArticleJMA journal2026

Preoperative Noble and Underwood Score in Colorectal Cancer Surgery: A Stable Prognostic Marker Even among Tumor Marker-Negative Cases.

Masayuki Urabe, Masaya Hiyoshi, Mami Suzuki, Takahiro Fukai, Yui Hasegawa, Emi Terai, Yoshitaka Kiya, Goki Morizono, Toshiyuki Watanabe, Yojiro Hashiguchi

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Article in JMA journal, 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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2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Masayuki UrabeGastrointestinal Surgery Division, Department of Surgery, Japanese Red Cross Omori Hospital, Tokyo, Japan.
Masaya HiyoshiGastrointestinal Surgery Division, Department of Surgery, Japanese Red Cross Omori Hospital, Tokyo, Japan.
Mami SuzukiGastrointestinal Surgery Division, Department of Surgery, Japanese Red Cross Omori Hospital, Tokyo, Japan.
Takahiro FukaiGastrointestinal Surgery Division, Department of Surgery, Japanese Red Cross Omori Hospital, Tokyo, Japan.
Yui HasegawaGastrointestinal Surgery Division, Department of Surgery, Japanese Red Cross Omori Hospital, Tokyo, Japan.
Emi TeraiGastrointestinal Surgery Division, Department of Surgery, Japanese Red Cross Omori Hospital, Tokyo, Japan.
Yoshitaka KiyaGastrointestinal Surgery Division, Department of Surgery, Japanese Red Cross Omori Hospital, Tokyo, Japan.
Goki MorizonoGastrointestinal Surgery Division, Department of Surgery, Japanese Red Cross Omori Hospital, Tokyo, Japan.
Toshiyuki WatanabeGastrointestinal Surgery Division, Department of Surgery, Japanese Red Cross Omori Hospital, Tokyo, Japan.
Yojiro HashiguchiGastrointestinal Surgery Division, Department of Surgery, Japanese Red Cross Omori Hospital, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Reliable and widely applicable tools for survival risk stratification in colorectal cancer (CRC) remain to be established. Although the Noble and Underwood (NUn) score, comprising white blood cell count, C-reactive protein, and serum albumin, has been reported to possess prognostic relevance in some malignancies, its role in CRC has yet to be elucidated. We retrospectively evaluated the association between the preoperative NUn score and survival outcomes in patients with resectable CRC. Methods: A total of 608 consecutive patients who underwent curative resection for CRC were analyzed. The impact of the preoperative NUn score on overall survival (OS) and relapse-free survival (RFS) was assessed using Cox proportional hazards models. Optimal cutoff values were determined using X-tile software. Results: The median follow-up period was 65 months. Kaplan-Meier analyses demonstrated that the preoperative NUn score effectively stratified OS and RFS, including among tumor marker-negative cases. In univariate analyses, a high NUn score was significantly associated with worse OS and RFS. Multivariate analyses adjusted for clinically relevant factors, including tumor marker positivity, confirmed that a high NUn score independently predicted worsened OS (hazard ratio [HR] 2.06, 95% confidence interval [CI] 1.24-3.41, p = 0.016) and RFS (HR 1.66, 95% CI 1.09-2.53, p = 0.011). These independent associations remained robust when the NUn score was analyzed as a continuous variable. Conclusions: The preoperative NUn score independently predicted survival outcomes in resectable CRC and may serve as a practical tool to support individualized therapeutic decision-making.

Indexed as

colorectal cancerNoble and Underwood scoreNUn scoreprognosissurgery

Identifiers

PMID42840707
PMCPMC13639637

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