To evaluate the relationship of preoperative neutrophil-lymphocyte ratio (NLR) with clinicopathological features and prognosis of colorectal cancer in middle-aged and elderly patients.

A retrospective analysis was performed in 212 patients with colorectal cancer in the First Affiliated Hospital of Nanjing Medical University from January 2011 to June 2013.All patients were divided into middle-aged group (46-65 year old, n=130) and old-aged group (66-89 year old, n=82). The optimal cut-off point of NLR was identified by the area under receiver operating characteristic curve, while NLR > 3.13 and NLR≤3.13 were classified as high and low NLR group.The clinicopathological features and prognosis between the two groups were compared.

There was no difference in gender, tumor growth site, depth of invasion, tumor embolus, lymphatic metastasis, distant metastasis, TNM stage between low and high NLR group (allP> 0.05). However, the difference between high NLR group and low NLR group in old-aged group with diabetes mellitus was statistically significant (P<0.05). The 1-, 2-, and 3-year survival rate of the overall 212 patients were 96.2% (204/212), 87.7% (186/212) and 74.5% (158/212). In middle-aged group, the 1-, 2-, and 3-year survival rates were 98.8% (85/86), 90.7% (78/86) and 84.9% (73/86) respectively in low NLR group, but 95.5% (42/44), 84.1% (37/44) and 72.7% (32/44) respectively in high NLR group, (allP<0.05). In old-aged group, the 1-, 2-, and 3-year survival rates were 95.7% (44/46), 89.1% (41/46) and 73.9% (34/46) respectively in low NLR group, but 91.7% (33/36), 83.3% (30/36) and 52.8% (19/36) respectively in high NLR group (all P<0.05). Cox regression showed that TNM stage and NLR were independent risk factors for the prognosis of the middle-aged and elderly patients with colorectal cancer (P<0.05 or P<0.01).

Preoperative NLR > 3.13 suggest that the prognosis is poor in middle-aged and elderly patients with colorectal cancer.

Colorectal neoplasms; Neutrophils; Lymphocytes; Prognosis