Impact of Preoperative Neutrophil to Prealbumin Ratio Index (NPRI) on Short-Term Complications and Long-Term Prognosis in Patients Undergoing Laparoscopic Radical Surgery for Colorectal Cancer.

Objective: This study aims to evaluate the impact and predictive value of the preoperative NPRI on short-term complications and long-term prognosis in patients undergoing laparoscopic radical surgery for colorectal cCancer (CRC). Methods: A total of 302 eligible CRC patients were included, assessing five inflammation-and nutrition-related markers and various clinical features for their predictive impact on postoperative outcomes. Emphasis was on the novel indicator NPRI to elucidate its prognostic and predictive value for perioperative risks. Results: Multivariate logistic regression analysis identified a history of abdominal surgery, prolonged surgical duration, CEA levels ≥5 ng/mL, and NPRI ≥ 3.94 × 10-2 as independent risk factors for postoperative complications in CRC patients. The Clavien--Dindo complication grading system highlighted the close association between preoperative NPRI and both common and severe complications. Multivariate analysis also identified a history of abdominal surgery, tumor diameter ≥5 cm, poorly differentiated or undifferentiated tumors, and NPRI ≥ 2.87 × 10-2 as independent risk factors for shortened overall survival (OS). Additionally, a history of abdominal surgery, tumor maximum diameter ≥5 cm, tumor differentiation as poor/undifferentiated, NPRI ≥ 2.87 × 10-2, and TNM Stage III were determined as independent risk factors for shortened disease-free survival (DFS). Survival curve results showed significantly higher 5-year OS and DFS in the low NPRI group compared to the high NPRI group. The incorporation of NPRI into nomograms for OS and DFS, validated through calibration and decision curve analyses, attested to the excellent accuracy and practicality of these models. Conclusion: Preoperative NPRI independently predicts short-term complications and long-term prognosis in patients undergoing laparoscopic colorectal cancer surgery, enhancing predictive accuracy when incorporated into nomograms for patient survival.

"Fast First and Then Slowly" Steroid-Tapering Regimen in Managing Corticoid-Sensitive Patients With Severe Immunotherapy Complications After Anti-PD-(L)1 Therapy for Cancer.

Background: We aimed to assess the efficacy of the "fast first and then slowly" steroid-tapering regimen used in managing corticoid-sensitive patients with severe irAE after anti-PD-(L)1 therapy. Corticosteroids are the primary therapy for severe immune-related adverse events (irAEs). Less is known about the standard steroid-tapering regimen for corticoid-sensitive patients. Methods: This study was a single-center, retrospective medical record review of patients with severe irAE after anti-PD-(L)1 treatment for cancer from October 13, 2021 to October 20, 2022. The efficacy was assessed by Common Terminology Criteria for Adverse Events (CTCAE) grading system. Results: Among the 187 patients with severe irAEs associated with immune checkpoint inhibitors (ICIs), 136 (72.7%) cases were corticoid-sensitive, and 96 (51.3%) cases were scheduled "fast first and then slowly" steroid-tapering regimen. And of these, 87 (90.6%) cases got irAEs solution. Conclusions: The "fast first and then slowly" steroid-tapering regimen stayed shorter in the hospital. More studies are needed to confirm this efficacy and find more details about the steroid-tapering regimen.