Efficacy of neutrophil-to-lymphocyte ratio for cancer prognosis in elderly patients with colon cancer: A single center propensity score-matched analysis

Abstract Background The prognostic value of neutrophil-to-lymphocyte ratio (NLR) has been studied for several cancers, including colon cancer. Elderly patients in general tend to have comorbidities, poor performance status, and decreased organ function that potentially influence the NLR score. The aim of this study was to investigate the relationship between NLR and cancer prognosis in elderly patients with colon cancer, using a propensity score-matched analysis. Methods A total of 203 patients aged over 75 years who underwent curative resection for colon cancer and were diagnosed pathologically with stage II/III disease were eligible for entry to the study. Patients were divided into two groups according to NLR score: NLR-High (NLR ≥ 4.5) group (NLR-H, n = 60) and NLR-Low (NLR < 4.5) group (NLR-L, n = 143). After propensity score matching, 57 patients in each group were matched. Results Before matching, ASA-PS (p = 0.002) and the presence of comorbidities (80.0% vs. 58.1%, p = 0.003) were significantly poor in the NLR-H group. After matching, all factors were similar between the groups. The median follow-up period was 43 months (range, 1–160 months). The 5-year RFS was significantly lower in the NLR-H group (65.6% vs. 85.8%, p = 0.001) after matching. The 5-year relapse-free-survival (69.8% vs. 87.3%, p = 0.030) and cancer-specific-survival (83.0% vs. 96.0%, p = 0.042) were significantly lower in the NLR-H group. Conclusions NLR appears to be a prognostic marker in elderly patients with colon cancer.