Inflammation-Based Prognostic Indicators in Oncology

The interplay between systemic inflammatory response and tumour biology has emerged as a critical determinant of cancer prognosis. Indices such as the C-reactive protein-to-albumin ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and prognostic nutritional index integrate routine laboratory measures to stratify patients by risk. Elevated inflammatory markers often reflect tumour-driven cytokine cascades, host nutritional status and immune dysregulation, correlating with poorer overall and progression-free survival across a broad range of malignancies. These scores offer global applicability owing to their simplicity, low cost and reproducibility, facilitating risk-adapted therapy, surveillance intensity and supportive care. Moreover, dynamic assessment of inflammatory indicators can inform treatment response and early detection of relapse.

Research from Nature Portfolio

Recent studies have refined the prognostic utility of combined inflammatory-nutritional metrics. In head and neck cancer, pretreatment C-reactive protein-to-albumin ratio and post-treatment prognostic nutritional index have emerged as independent predictors of progression-free and overall survival, enabling dynamic risk stratification before and after chemoradiotherapy. Seminal work in small-cell lung carcinoma demonstrated that an elevated pretreatment C-reactive protein-to-albumin ratio independently predicts shorter survival, with prognostic accuracy comparable to established markers such as disease stage and performance status. These findings underscore the translational potential of inflammation-based scores in guiding therapeutic decisions and tailoring follow-up strategies.

Inflammation-Based Prognostic Indicators in Oncology publication trend

The graph below shows the total number of articles in inflammation-based prognostic indicators in oncology across all publications each year (not limited to Nature Index journals).

Technical terms

C-reactive protein-to-albumin ratio (CAR): A combined measure of systemic inflammation (C-reactive protein) and nutritional status (albumin), used as a prognostic score.

Neutrophil-to-lymphocyte ratio (NLR): The ratio of circulating neutrophils to lymphocytes, reflecting systemic inflammatory activity.

Platelet-to-lymphocyte ratio (PLR): A prognostic index based on platelet and lymphocyte counts, indicative of inflammatory and immunological status.

Prognostic nutritional index (PNI): A score derived from albumin concentration and lymphocyte count to assess nutritional and immune competence.

Overall survival (OS): The duration from diagnosis or treatment initiation to death from any cause.

Progression-free survival (PFS): The interval from treatment start to objective tumour progression or death.

References

1. Prognostic significance of pre- and post-treatment hematological biomarkers in patients with head and neck cancer treated with chemoradiotherapy. Scientific Reports (2023).
2. Ratio of C-Reactive Protein/Albumin is An Inflammatory Prognostic Score for Predicting Overall Survival of Patients with Small-cell Lung Cancer. Scientific Reports (2015).
3. Preoperative C-reactive protein to albumin ratio may be a good prognostic marker in patients undergoing hepatectomy for hepatocellular carcinoma: a meta-analysis. Frontiers in Nutrition (2024).
4. C-Reactive Protein-to-Albumin Ratio to Predict Tolerability of S-1 as an Adjuvant Chemotherapy in Pancreatic Cancer. Cancers (2024).
5. Postoperative ratio of C-reactive protein to albumin is an independent prognostic factor for gastric cancer. European Journal of Medical Research (2023).