Prognostic significance of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with stage III and IV colorectal cancer

Table 1 Baseline clinical characteristics of the enrolled patients

Characteristics	Patients (n = 1868)
Mean age (range), yr	65 (28-93)
Gender
Male	1072 (57.4)
Female	796 (42.6)
Location
Colon	892 (47.8)
Rectum	957 (51.2)
Unknown	19 (1.0)
Histology
Well differentiated	484 (25.9)
Moderate differentiated	1066 (57.1)
Poorly differentiated	139 (7.4)
Unknown	179 (9.6)
Tumor stage
I	281 (15.0)
II	551 (29.5)
III	667 (35.7)
IV	369 (19.8)
Chemotherapy
No	294 (15.8)
Yes	1574 (84.2)

Values are presented as mean (range) or n (%).

Table 2 Clinicopathological findings according to neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio

Variable	NLR < 3.0	NLR ≥ 3.0	P value	PLR < 160	PLR ≥ 160	P value
	(n = 1086)	(n = 782)		(n = 973)	(n = 894)
T stage			< 0.001			< 0.001
T1	112	39		112	39
T2	171	91		159	102
T3	668	498		579	587
T4	48	59		41	66
Unknown	87	95		82	100
N stage			0.854			0.443
N0	589	434		543	480
N1	289	201		257	232
N2	196	138		164	170
Unknown	12	9		9	12
Lymphatic invasion			0.421			0.446
Yes	349	253		311	291
No	587	391		524	453
Unknown	150	138		138	150
Vascular invasion			0.243			0.011
Yes	193	149		160	182
No	742	496		675	562
Unknown	151	137		138	150
Peri-neural invasion			0.045
Yes	168	142		141	169	0.004
No	767	502		693	575
Unknown	151	138		139	150

NLR: Neutrophil-to-lymphocyte-ratio; PLR: Platelet-to-lymphocyte-ratio.

Table 3 Overall survival and disease free survival according to neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio

	NLR		PLR
	Low (< 3.0)	High (≥ 3.0)	Low (< 160)	High (≥ 160)
Overall survival
Stage I
3-yr OS rate	97.0%	98.2%	99.3%	94.7%
5-yr OS rate	92.6%	91.9%	94.8%	87.3%
Stage II
3-yr OS rate	91.2%	89.2%	90.6%	90.1%
5-yr OS rate	86.1%	84.0%	84.3%	86.2%
Stage III
3-yr OS rate	79.6%	73.4%	82.1%	71.4%
5-yr OS rate	69.3%	60.9%	69.6%	61.9%
Stage IV
3-yr OS rate	39.8%	21.2%	33.9%	27.4%
5-yr OS rate	34.3%	18.1%	28.6%	23.8%
Disease free survival
Stage I
3-yr DFS rate	98.3%	97.4%	98.7%	96.6%
5-yr DFS rate	96.1%	95.6%	97.2%	93.3%
Stage II
3-yr DFS rate	88.5%	89.3%	87.8%	89.9%
5-yr DFS rate	84.7%	86.5%	83.5%	87.5%
Stage III
3-yr DFS rate	79.2%	78.1%	79.8%	77.2%
5-yr DFS rate	75.2%	68.6%	74.5%	70.5%
Stage IV
3-yr DFS rate	42.2%	30.3%	38.5%	34.5%
5-yr DFS rate	37.5%	26.8%	34.3%	30.4%

NLR: Neutrophil-to-lymphocyte-ratio; PLR: Platelet-to-lymphocyte-ratio; OS: Overall survival; DFS: Disease frees survival.

Table 4 Prognostic factors by multivariate Cox regression analysis (Stage I and II)

Predictor	OS			DFS
	HR	95%CI	P value	HR	95%CI	P value
Age
< 60 yr	1.00			1.00
≥ 60 yr	1.72	1.08-2.76	0.023	1.44	0.91-2.28	0.123
Histology
Well/moderate differentiated	1.00			1.00
Poorly differentiated	1.57	0.72-3.47	0.260	2.46	1.25-4.81	0.009
T stage
T1/T2	1.00			1.00
T3/T4	1.66	0.95-2.90	0.074	1.62	0.94-2.80	0.084
Lymphatic invasion
No	1.00			1.00
Yes	0.77	0.46-1.28	0.306	1.02	0.62-1.68	0.931
Vascular invasion
No	1.00			1.00
Yes	2.36	1.46-3.84	< 0.001	1.11	0.64-1.95	0.708
Peri-neural invasion
No	1.00			1.00
Yes	2.64	1.59-4.35	< 0.001	3.08	1.86-5.09	< 0.001
NLR
Low NLR (< 3.0)	1.00			1.00
High NLR (≥ 3.0)	1.16	0.76-1.76	0.498	1.06	0.69-1.62	0.788
PLR
Low PLR (< 160)	1.00			1.00
High PLR (≥ 160)	1.07	0.71-1.62	0.744	0.98	0.64-1.49	0.908

NLR: Neutrophil-to-lymphocyte-ratio; PLR: Platelet-to-lymphocyte-ratio; OS: Overall survival; DFS: Disease free survival.

Table 5 Prognostic factors by multivariate Cox regression analysis (Stage III and IV)

Predictor	OS			DFS
	HR	95%CI	P value	HR	95%CI	P value
Age
< 60 yr	1.00			1.00
≥ 60 yr	1.46	1.13-1.89	0.004	1.10	0.84-1.44	0.479
Histology
Well/Moderate differentiated	1.00			1.00
Poorly differentiated	1.90	1.36-2.66	< 0.001	1.46	0.98-2.14	0.058
T stage
T1/T2	1.00			1.00
T3/T4	2.61	1.51-4.51	0.001	3.13	1.69-5.78	< 0.001
Lymphatic invasion
No	1.00			1.00
Yes	1.19	0.91-1.58	0.199	1.17	0.87-1.57	0.298
Vascular invasion
No	1.00			1.00
Yes	1.52	1.15-2.01	0.003	1.39	1.03-1.87	0.031
Peri-neural invasion
No	1.00			1.00
Yes	1.45	1.10-1.91	0.008	1.56	1.16-2.08	0.003
NLR
Low NLR (< 3.0)	1.00			1.00
High NLR (≥ 3.0)	1.44	1.14-1.83	0.003	1.43	1.11-1.85	0.005
PLR
Low PLR (< 160)	1.00			1.00
High PLR (≥ 160)	1.35	1.06-1.73	0.017	1.32	1.02-1.69	0.034

NLR: Neutrophil-to-lymphocyte-ratio; PLR: Platelet-to-lymphocyte-ratio; OS: Overall survival; DFS: Disease free survival.