Preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as new prognostic factors for patients with colorectal cancer

Purpose: The objective of this study was to preoperatively evaluate blood platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) for their prognostic value in patients with colorectal cancer (CRC). Methods: We retrospectively reviewed 347 patients who underwent colorectal surgery for CRC in the Istanbul Education and Research Hospital and the Antalya Education and Research Hospital. The prognostic value of preoperative PLR, NLR, and other clinical and laboratory parameters was assessed with univariate and multivariate analysis. Results: Median overall survival (OS) was 61.8 months [95% CI for hazard ratio (HR) 46.24-77.14]. Significant parameters in univariate analysis, which were the preoperative levels of carcinoembryonic antigen (CEA) (p=0.055), albumin (p =0.003), hemoglobin (p=0.012), PLR (p=0.004), and NLR (p =0.054) were assessed by multivariate analysis which showed that only albumin retained its significance (p=0.008). Median OS was 70.1 vs 44.8 months with PLR <= 180 vs PLR > 180 (log rank; p=0.005). Median OS was "Not reached" (NR) vs 43.5 months with NLR <= 3 vs NLR > 3 (log rank; p=0.012). Conclusions: This study showed that preoperative levels of CEA, albumin, PLR, and NLR have significant prognostic value for patients with CRC.