A high preoperative neutrophil-to-lymphocyte ratio is associated with poor survival in patients with colorectal cancer.

Background: Previous studies have reported that an elevated preoperative neutrophil-to-lymphocyte ratio (NLR) is associated with a poor prognosis in patients with various types of cancers. The aim of this study was to determine the prognostic significance of preoperative NLR in patients with colorectal cancer and to determine an appropriate cut-off value of the NLR.

Patients And Methods: We enrolled 674 patients who underwent surgery for stage I-IV colorectal cancer. The mean NLR was 2.74±2.20. To determine the appropriate cut-off value of the NLR, we used a receiver operating characteristic curve. A total of 262 patients with an NLR of 2.5 or more were classified as high-NLR individuals in this study. The prognostic significance of a high NLR was evaluated using a multivariate analysis.

Results: The cancer-specific survival was significantly (p<0.001) worse in the patients with a high NLR. The multivariate analysis indicated that the tumor diameter, the presence of lymph node or distant metastasis, and a high NLR were independent risk factors for poor survival.

Conclusion: Preoperative NLR measurement is a convenient biomarker and predictor of a poor prognosis after surgery for colorectal cancer.