Abstract
This study evaluated the prognostic value of the pan-immune-inflammation value (PIV) combined with the albumin-to-globulin ratio (AGR) for postoperative survival in colorectal cancer (CRC) patients and developed a nomogram for survival prediction. A total of 650 CRC patients who underwent radical surgery were included, with data from one institution used as the training set. The optimal cut-off values for PIV (426.8) and AGR (1.4) were determined using maximally selected rank statistics. Kaplan-Meier analysis showed that patients in the low-PIV group had significantly better 5-year overall survival (OS) compared to the high-PIV group, while those in the high-AGR group had better 5-year OS than those in the low-AGR group. Multivariate analysis identified age, N stage, degree of differentiation, PIV, and AGR as independent prognostic factors for OS. A nomogram for OS was developed and validated, demonstrating robust predictive performance. This study highlights the value of PIV and AGR as reliable indicators for predicting OS in CRC patients, with high PIV and low AGR associated with worse prognosis. Timely interventions may improve patient outcomes.