Efficacy of Neutrophil-to-Lymphocyte Ratio for Cancer-Specific Survival in Elderly Patients with Localized Colon Cancer: A Single Center Propensity Score-Matched Analysis

Tetsuro Tominaga, Takashi Nonaka, Shosaburo Oyama, Yuma Takamura, Shintaro Hashimoto, Toshio Shiraishi, Terumitsu Sawai, Takeshi Nagayasu Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, JapanCorrespondence: Tetsuro Tominaga, Department of Surgical Oncology, Nagasaki University Graduate School of Biological Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan, Tel +81-95-819-7304, Fax +81-95-819-7306, Email tetsuro.tominaga@nagasaki-u.ac.jpPurpose: The prognostic value of neutrophil-to-lymphocyte ratio (NLR) has been studied for colorectal cancer. Elderly patients in general tend to have comorbidities and decreased organ function that potentially influence the NLR score. The aim of this study was to investigate the relationship between NLR and cancer-specific survival in elderly patients with colon cancer, using a propensity score-matched analysis.Patients and 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, Charlson comorbidity index was significantly higher in the NLR-H group (4 vs 2, p< 0.001). After matching, all factors were similar between the groups. The median follow-up period was 43 months (range, 1– 160 months). Five-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.Conclusion: NLR appears to be a cancer-specific prognostic marker in elderly patients with colon cancer.Keywords: cancer-specific survival, colon cancer, neutrophil-to-lymphocyte ratio