Tumor node metastasis (TNM) staging system is the most useful method in predicting prognosis of colorectal cancer (CRC), the third most common cause of death worldwide, even if other biological markers are currently under evaluation to assess their role in affecting CRC outcome and planning the best tailored therapeutic approach. Several molecular factors are being demonstrated to be effective in influencing both overall survival (OS) and disease-free survival (DFS) in CRC, acting on different aspects of tumor promoting and progression.

Patient inflammatory and nutritional status evaluation, strictly correlated with immune-surveillance system, plays a crucial role in affecting CRC outcome.

The Authors, analyzing data of 562 consecutives CRC patients, suggest a new prognostic model, called Naples Prognostic Score (NPS), for an exhaustive assessment of both inflammatory and nutritional status through the determination of several routine blood parameters. NPS is an independent factor in affecting outcome of CRC patients undergoing surgery with a power almost similar to TNM pathological system.

NPS results by albumin and total cholesterol serum levels, neutrophils to lymphocyte ratio (NRL) and lymphocyte to monocytes ratio (LMR); the score stratifies CRC patients in three homogeneous groups that are significantly different in terms of advanced stages, postoperative complication rate, DFS and OS.

Further studies with higher numbers of patients are necessary to standardize NPS routine use to become a reference model to modified management and integrated treatment of CRC patients.

Tumor node metastasis (TNM), Overall survival (OS), Disease-free survival (DFS), Colorectal cancer (CRC)