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

Background 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). Materials and methods 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. Results 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. Conclusion 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.