Is nutritional status a new indicator to use in clinical practice for colorectal cancer patients?

Table 1 Most frequently reported inflammation-related biomarkers for the prediction of prognosis in colorectal cancer patients as shown in previous reports[9]

Inflammation-related biomarkers
Neutrophil-related markers	NLR: Low NLR was related to better CSS and DFS, with different cut-off values depending on the study: The smallest was 2, while the largest was 5
Albumin-related markers	GPS that includes serum CRP levels and serum albumin levels: High GPS indicated systemic inflammation (elevated CRP) and low nutritional state (hypoalbuminemia), that was associated with lower CSS and DFS
Monocyte-related markers	Monocyte count: Elevated monocyte count was significantly associated with poor OS and DFS, with variable cut off values depending on the study. LMR: Low LMR was independently associated with worse OS and DFS. The cutoff value depended on the study
C-reactive protein-related markers	CAR: Elevated CAR was significantly associated with worse OS and RFS in patients who underwent curative resection. The cutoff value varied between 0.025 and 0.22 according to the study. LCR: Low LCR (cut off between 12980 and 6000 depending on the study) was most significantly and independently correlated with worse OS and DFS. CLR: Was reported as an independent and significant indicator of poor long-term outcomes in patients with CRCm after hepatic resection, with a cutoff level of 62.8 × 10-6[10]
Platelet-related markers	PLR: High PLT reflects both an increase in PLT count and a decrease in lymphocyte count and was negatively related to OS in previous reports on colorectal cancer. The cutoff value varied among studies from 150 to 246.36

CSS: Cancer-specific survival; DFS: Disease-free survival; GPS: Glasgow prognostic score; CRP: C-reactive protein; OS: Overall survival; LMR: Lymphocyte–monocyte ratio; CAR: C-reactive protein–albumin ratio; LCR: Lymphocyte–C-reactive protein ratio; CLR: C-reactive protein–lymphocyte ratio; CRCm: Metastatic colorectal cancer; PLR: Platelet–lymphocyte ratio; PLT: Platelet.

Table 2 Definition of controlling nutritional status score

Variable	Normal	Light	Moderate	Severe
Albumin (g/dL)	3.5-4.5	3.0-3.49	2.5-2.9	< 2.5
Albumin score	0	2	4	6
Total lymphocyte count (mm3)	≥ 1600	1200-1599	800-1199	< 800
Total lymphocyte count score	0	1	2	3
Total cholesterol (mg/dL)	< 180	140-180	100-139	< 100
Total cholesterol score	0	1	2	3
CONUT score	0-1	2-4	5-8	9-12
Assessment	Normal	Light	Moderate	Severe

Low controlling nutritional status (CONUT) score includes: Normal (0-1) and light (2-4) subgroups. High CONUT score includes: Moderate (5-8) and severe (9-12) subgroups[6]. CONUT: Controlling nutritional status.