ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1589854
The Association Between Neutrophil Percentage to Albumin Ratio and Progression-Free Survival and Overall Survival in Colorectal Cancer Patients: A Retrospective Cohort Study
Provisionally accepted
- 1Department of Gastrointestinal Gland Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Region, China
- 2Geriatric Respiratory Disease Ward, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi Zhuang Region, China
- 3Department of pharmacy, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi Zhuang Region, China
- 4Department of Colorectal Anal Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
The neutrophil percentage-to-albumin ratio (NPAR) is a promising indicator for predicting outcomes in various cancers. However, its prognostic value in colorectal cancer (CRC) is still underexplored. This study aimed to investigate the relationship between NPAR and progression-free survival (PFS) as well as overall survival (OS) in CRC patients. We conducted a retrospective cohort study involving 1,339 CRC patients who underwent surgical resection. The Kaplan-Meier method was utilized to plot survival curves for PFS and OS. Cox proportional hazards regression analysis assessed the relationship between NPAR and survival outcomes. The nomograms that included NPAR and other significant prognostic factors were developed to predict 1-, 3-, and 5-year survival rates. Patients with high NPAR (≥1.62) experienced significantly worse PFS and OS compared to those with low NPAR (<1.62) (PFS: 47.4% vs. 63.1%, p < 0.001; OS: 50.1% vs. 65.9%, p < 0.001). Compared to other relevant markers, NPAR exhibited strong prognostic predictive efficacy. Multivariate Cox regression analysis identified high NPAR as an independent predictor of poor PFS (hazard ratio [HR] = 1.671, 95% Confidence Interval [CI]: 1.142-2.444, p = 0.008) and OS (HR = 2.697, 95% CI: 1.761-4.130, p < 0.001). The NPAR-based nomograms demonstrated high predictive accuracy and received favorable evaluations in the internal validation cohort. Preoperative NPAR is a promising indicator for predicting PFS and OS in CRC patients. The NPAR-based nomogram offers a practical tool for personalized survival prediction and may assist in clinical decision-making.
Keywords: Neutrophil percentage, albumin, colorectal cancer, Progression-free survival, overall survival
Received: 08 Mar 2025; Accepted: 16 Jun 2025.
Copyright: © 2025 Xie, Wei, 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:
Shuangyi Tang, Department of pharmacy, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi Zhuang Region, China
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.