Hematological markers as prognostic predictors in patients undergoing colon cancer surgery

To determine if neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR), can predict postoperative complications (PC), 5-year survival, and 5-year disease-free survival (DFS) in stages I-III colon adenocarcinoma, analyzing outcomes generally and by tumor location (right colon vs. left colon). A retrospective multicenter cohort study analyzed patients who underwent surgery for colon adenocarcinoma with curative intent between January 2007 and December 2017. Patients were in stages I to III with at least 5 years of follow-up. Exclusion criteria included urgent surgeries, active infections, immunosuppression, rectal neoplasia, stage IV, or unresectable tumors. NLR, LMR, PLR, PC, survival, and DFS were analyzed adjusting for demographic and clinical variables. Optimal cutoff points were determined using receiver operating characteristic curves. Multivariable logistic models were performed both generally and by tumor location. The study included 805 patients with a 5-year survival rate of 75.28% and DFS of 76.27%. Multivariable analysis showed lower survival and DFS with NLR > 3.09, LMR < 2.40, and PLR > 145.16. In right-sided colon tumors, NLR and LMR were associated with 5-year survival. In left-sided colon tumors, LMR was linked to survival and DFS and NLR > 2.79 was associated with increased risk of postoperative anastomotic leaks. NLR, LMR and PLR are effective predictor of survival and DFS in colon cancer. High NLR is associated with an increased risk of anastomotic leaks. However, this associations change when analyzing by tumor location. This highlights the importance of considering tumor location in treatment planning and biomarker research for colon cancer.