Comparative Prognostic Role of PLR and NLR in Colon Cancer: A Retrospective Analysis of Preoperative Inflammatory Markers

Systemic inflammation plays a key role in cancer progression, and markers such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have gained attention as potential prognostic tools in colorectal cancer. However, their comparative utility in colon cancer remains unclear. <i>Objective</i>: This study was aimed to assess and compare the prognostic value of preoperative NLR and PLR in evaluating tumor aggressiveness in colon cancer patients undergoing elective surgery. <i>Methods</i>: We conducted a retrospective observational study on 64 patients with histologically confirmed colon cancer treated between 2019 and 2022. Only elective cases were included; rectal and emergency surgeries were excluded. Demographic, clinical, pathological, and laboratory data were collected. Tumor aggressiveness was assessed based on tumor size, histologic grade, lymphovascular and perineural invasion, and lymph node involvement. Statistical analysis included Pearson correlation, ANCOVA, logistic regression, and principal component analysis (PCA). <i>Results</i>: PLR showed a significant positive correlation with tumor size (r = 0.428, <i>p</i> < 0.001) and tumor stage (r = 0.314, <i>p</i> = 0.012), whereas NLR did not. Logistic regression and PCA indicated that PLR better reflected tumor burden, while NLR was more associated with systemic inflammation. Neither marker significantly predicted postoperative complications or in-hospital mortality. <i>Conclusions</i>: PLR may serve as a useful, non-invasive biomarker for assessing tumor aggressiveness in colon cancer, supporting its integration into preoperative risk stratification. The results from this single-center, retrospective cohort showed moderate associations between PLR and tumor size and stage, whereas NLR did not. These findings are hypothesis-generating and insufficient for clinical implementation; prospective, adequately powered studies with survival endpoints are required.