Evaluation of Preoperative Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio for their Predictive Value in Determining Short-Term Mortality in Patients with Operable Colorectal Cancers

Abstract

Aim: The aim of this study was to investigate whether preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have a predictive value in short-term mortality in patients with operable colorectal cancer (CRC). Material and Methods: A total of 231 (93 female, 138 male) patients with operated CRC between 2016 and 2021 in a university hospital were analyzed retrospectively. Median age was 68 (range, 26-92) years and patients had been under follow-up for a median of 25 (range, 0-54) months. Patients were grouped with respect to survival, those who were alive (n=175) and those who died (n=56) during the follow-up. Results: The area under the curve for NLR was 0.649 (95% CI: 0.563-0.734, p=0.001), optimal cut-off was 5.08 and demonstrated a sensitivity of 48.2% and a specificity of 81.7% for predicting mortality. The area under the curve for PLR was 0.635 (95% CI: 0.546-0.723, p=0.002), optimal cut-off was 221.5 and demonstrated a sensitivity of 55.4% and a specificity of 72.0%. Multiple regression analysis revealed that recurrence (OR: 60.910, 95% CI: 9.807-378.319, p=<0.001), leakage (OR: 10.724, 95% CI: 1.281-89.747, p=0.029), high NLR (OR: 3.735, 95% CI: 1.602-8.711, p=0.002) and higher age (OR: 1.136, 95% CI: 1.081-1.193, p<0.001) were independently associated with mortality. Conclusion: The results of this study support studies indicating that preoperative NLR and PLR are effective in predicting short-term mortality in CRC patients who underwent surgical resection. Although further studies are necessary, these biomarkers are promising for future use as prognostic tools in CRC patients.