# Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as prognostic factors in patients with colorectal cancer: a retrospective study

## TL;DR

This study found that a high neutrophil-to-lymphocyte ratio (NLR) is linked to worse survival in colorectal cancer patients, especially in younger individuals.

## Contribution

The study identifies NLR as an independent prognostic factor for cancer-specific survival in colorectal cancer.

## Key findings

- High NLR (≥3.19) was associated with worse overall and cancer-specific survival in CRC patients.
- NLR remained a significant predictor of cancer-specific survival after adjusting for confounding factors.
- PLR did not show significant associations with survival outcomes in this study.

## Abstract

Colorectal cancer (CRC) is a leading cause of cancer-related deaths worldwide. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been investigated as potential prognostic biomarkers. This study aims to evaluate the association between NLR and PLR with CRC across age groups and assess their prognostic value for overall survival (OS) and cancer-specific survival (CSS).

This is a retrospective study conducted on 285 CRC patients who underwent elective colectomy. Sociodemographic and clinicopathological characteristics were collected from electronic records. Preoperative NLR and PLR were calculated from blood samples. Descriptive analyses, multivariable logistic regression analyses, and survival analyses using Cox regression and Kaplan–Meier tests were used.

The highest median NLR was 4.54 and found among the youngest age group (<50 years). High NLR, defined as a value ≥3.19, was associated with worse OS (HR 2.23, p = 0.02) and CSS (HR 2.9, p < 0.05). After adjusting for confounding factors, high NLR remained significantly associated with worse CSS (adjusted HR = 2.89, p = 0.02). PLR did not show any significant associations with OS or CSS. Age, smoking status, and BMI were also independent prognostic factors for OS.

High NLR was identified as an independent prognostic factor for worse CSS in CRC patients. The association between NLR and PLR with CRC outcomes may vary across different age groups. These findings highlight the potential utility of NLR as a prognostic biomarker in CRC, particularly for CSS.