Ersin Borazan1, Ahmet Abdulhalik Balık1, Zehra Bozdağ2, Muhammed Kasım Arık3, Alper Aytekin1, Latif Yılmaz1, Muhsin Elçi1, İlyas Başkonuş1


Objective: Neutrophil-lymphocyte ratio still has a limited clinical use due to many non-cancer factors affecting neutrophils or lymphocytes in the present time. We aimed to evaluate the association between preoperative neutrophil-lymphocyte ratio and poor prognostic factors after curative elective colorectal surgery.
Material and Methods: This clinical retrospective study was initiated with 95 patients, who had a curative surgical resection between 2003 and 2013. The patients were divided into two groups based on the preoperative neutrophil-lymphocyte ratio cut-off value above and below 3. The groups were compared for tumor localization, diameter, and staging; the histopathological perineural invasion; lymphovascular invasion; and overall survival. Univariate and multivariate Cox regression analyses were used to determine the role of neutrophil-lymphocyte ratio after stratification by several clinicopathological factors.
Results: The mean age of patients was 59.79±1.48 (range, 23-90) years, and median follow-up period was 20.77±14.85 months. There was no significant difference in perineural or lymphovascular invasion, tumor size, stage, age, sex, and tumor location between the groups [Group 1 ratio >3 (n=52) and Group 2 ratio ≤3(n=43)]. Hemoglobin (p=0.035) and albumin levels (p=0.004) were lower in the Group 1. When the stage increased, differences between the rectal cancer groups were found. Overall survival was significantly lower in the Group 1 (p=0.013).
Conclusions: The study showed that a high neutrophil-lymphocyte ratio had an adverse effect on overall survival in colorectal cancer patients who had a curative surgery. However, we could not establish any association between neutrophil-lymphocyte ratio and the factors such lymphovascular invasion, perineural invasion, tumor size expect hemoglobin and serum albumin levels.

Keywords: Colorectal cancer, lymphocyte, neutrophil, surgery, overall survival

Cite this paper as: Borazan E, Balık AA, Bozdağ Z, Arık MK, Aytekin A, Yılmaz L, Elçi M, Başkonuş İ. Assessment of the relationship between neutrophil lymphocyte ratio and prognostic factors in non-metastatic colorectal cancer. Turk J Surg 2017; 33: 185-189.


Ethics Committee Approval

Ethics committee approval was received for this study from the ethics committee of Gaziantep University (20.01.2014/48).

Peer Review

Externally peer-reviewed.

Author Contributions

Concept - A.B., E.B.; Design - E.B., Z.B., K.A.; Supervision - A.B., E.B., İ.B.; Materials - A.B., E.B., İ.B., Z.B.; Data Collection and/or Processing - K.A., A.A., L.Y., M.E.; Analysis and/or Interpretation - E.B., K.A.; Literature Search - E.B., K.A., Z.B.; Writing Manuscript - E.B., A.A., L.Y.; Critical Reviews - A.B., İ.B.

Conflict of Interest

No conflict of interest was declared by the authors.

Financial Disclosure

The authors declared that this study has received no financial support.