Preoperative blood neutrophil-to-lymphocyte ratio, hematocrit and fibrinogen predict prognosis in colorectal cancer.

OBJECTIVE

To investigate the prognostic potential of preoperative blood neutrophil to lymphocyte ratio (NLR), hematocrit (HCT) and Fibrinogen (FIB) level in patients with colorectal cancer (CRC).

METHODS

The data of 268 patients with CRC who underwent radical surgery from March 2013 to August 2017 in the First Affiliated Hospital of Guangzhou Medical University (Guangzhou, China) were retrospectively collected. The correlations between preoperative blood NLR, HCT and FIB level and the clinicopathologic features and prognosis were explored by Cox regression in the patients with CRC.

RESULTS

Univariate and multivariate analyses identified preoperative blood with high NLR (HR = 2.265, 95% CI: 1.437-3.570), low HCT (HR = 1.575, 95% CI: 1.010-2.454), and high FIB (HR = 1.667, 95% CI: 1.067-2.605) as independent predictors of reduced 5-year overall survival (OS). Furthermore, the patients were stratified into high (with 3 predictors), middle (with 2 predictors) and low (with 0 or 1 predictors) risk groups according to the number of the 3 independent prognostic predictors. The more independent predictors a patient has, the poorer their prognosis tends to be.

CONCLUSIONS

Preoperative NLR, HCT, and FIB serve as cost-effective prognostic biomarkers in CRC. Their combination enables precise risk stratification, guiding personalized postoperative management.