Neutrophil-to-lymphocyte ratio is a good predictor of post-surgery complications in colorectal cancer

This study investigated the association between the neutrophil-to-lymphocyte ratio (NLR) and complications after surgery in patients with colorectal cancer. Researchers suggested that NLR levels are associated with post-surgery complication rates.

A high number of patients with colorectal cancer suffer from post-surgery complications. Prior studies reported that and elevated NLR (blood factor that predicts body´s inflammatory status) may be associated with post-operative complications. However, it is not clear which post-surgical complications are most common in patients with elevated NLR. 

The objective of this study was to determine whether patients undergoing surgery who have an elevated NLR are at increased risk of having post-surgery complications. Additionally, this study also aims to determine which complications are more common in patients with elevated NLR.

This study included information about 583 colorectal cancer patients who underwent surgery. The NLR was calculated for each patient 14 days before their surgery and the occurrence of one or more complications, as well as the severity of the complications, was registered.

Of 583, 170 (29%) had a complication. Wound infection was the most common (12%) complication, followed by gastrointestinal and respiratory complications (5%), anastomotic leakage (leakage of intestinal fluids; 4%) and blood loss (4%). Among these patients 11% had a NLR of 2.3 or greater and 5% had an NLR of 5 or greater.

A pre-surgery NLR greater than or equal to 2.3 was associated with a 2.5 times increased risk of having a complication when compared with patients with a NLR greater than or equal to 5. There was a trend for anastomotic leakage to be the most common complication in patients with a NLR greater than or equal to 2.3.

This study showed that NLR levels greater than or equal to 2.3 may be a good predictor of post-surgery complications in colorectal cancer.