Establishing the prognostic value of platelet-to-lymphocyte ratio in cervical cancer: a systematic review and meta-analysis

2019 ◽  
Vol 29 (4) ◽  
pp. 683-690 ◽  
Author(s):  
Lixiao Yang ◽  
Huixiao Chen

ObjectiveThe aim of this study was to conduct a meta-analysis to establish the prognostic value of platelet-to-lymphocyte ratio in cervical cancer.MethodsWe conducted a search in Medline and Embase datasets for articles published until May 1, 2018 to perform a meta-analysis to establish the prognostic value of platelet-to-lymphocyte ratio in cervical cancer. The primary survival outcomes were overall survival and progression-free survival. The pooled hazard ratios (HRs) and 95% confidence intervals (95% CIs) were combined to calculate overall effects. Cochran’s Q test and Higgins’ I2statistics were employed to estimate the heterogeneity. In addition, the subgroup analysis, sensitivity analysis, and meta-regression were performed to identify the source of heterogeneity. Egger’s linear regression test and Begg’s funnel plot and the trim and fill methods were employed to evaluate the publication bias.ResultsA total of 2616 patients from eight studies were enrolled in the meta-analysis. Significant association was observed between elevated platelet-to-lymphocyte ratio and a worse overall survival, with a combined HR of 1.49 (95% CI 1.24 to 1.79, I2=32.8%). Elevated platelet-to-lymphocyte ratio was significantly associated with a worse progression-free survival, with a combined HR of 1.65 (95% CI 1.17 to 2.33, I2= 49.4%). Subsequently, sensitivity analysis, subgroup analysis, and meta-regression model containing six predominant factors were applied to trace the origin of heterogeneity. However, no significant factors or studies were explored as the potential source of heterogeneity.ConclusionElevated pre-treatment platelet-to-lymphocyte ratio may be an adverse prognostic factor for overall survival and progression-free survival in patients with cervical cancer. Further investigations are warranted to determine the exact mechanism by which platelet-to-lymphocyte ratio impacts survival outcomes in cervical cancer.

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Rongqiang Liu ◽  
Shiyang Zheng ◽  
Qing Yuan ◽  
Peiwen Zhu ◽  
Biao Li ◽  
...  

Purpose. The prognostic value of a new scoring system, termed F-NLR, that combines pretreatment fibrinogen level with neutrophil-lymphocyte ratio has been evaluated in various cancers. However, the results are controversial. The purpose of this study was to comprehensively analyze the prognostic value of F-NLR score in patients with cancers. Methods. An integrated search of relevant studies was conducted by screening the PubMed and Embase databases. Pooled hazard ratios, with 95% confidence intervals (CIs), for overall survival (OS) and disease-free survival (DFS)/progression-free survival (PFS) were calculated to estimate the prognostic significance of F-NLR score in patients with various tumors. A random effects model was used for comprehensive analysis, and subgroup and meta-regression analyses were used to explore sources of heterogeneity. Results. Thirteen articles reporting data from of 4747 patients were included in the study. Pooled analysis revealed that high F-NLR score was significantly associated with poor OS ( HR = 1.77 ; 95% CI, 1.51–2.08) and poor DFS/PFS ( HR = 1.63 ; 95% CI, 1.30–2.05). Subgroup and meta-regression analyses did not alter the prognostic role of F-NLR score in OS and DFS/PFS. Conclusions. Increased F-NLR score is significantly associated with poor prognosis in patients with cancers and can serve as an effective prognostic indicator.


2020 ◽  
Vol 30 (11) ◽  
pp. 1689-1696 ◽  
Author(s):  
Youn Ji Kim ◽  
Young Saing Kim ◽  
Jin Woo Shin ◽  
Biche Osong ◽  
Seok Ho Lee

ObjectiveA scoring system based on clinicohematologic parameters in cervical cancer patients receiving chemoradiation has not been reported to date. The aim of this study was to determine the prognostic value of clinicohematologic parameters in patients with cervical cancer undergoing chemoradiation and to develop a prediction scoring system based on these results.MethodsA total of 107 patients who received definitive chemoradiation for cervical cancer were enrolled in this study. The clinical data and hematologic parameters were retrospectively reviewed, and their prognostic value in predicting survival was analyzed. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) and the changes in these hematologic parameters (ΔNLR, ΔPLR, and ΔLMR) between pre- and post-treatment were calculated to determine the specific value of these parameters for predicting patient survival.ResultsThe median follow-up time was 39.9 (range 2.7–114.6) months. The 3-year overall survival rate and progression-free survival rate were 80.9% (95% CI 72.7 to 90.0) and 53.4% (95% CI 44.1 to 64.8), respectively. The median progression-free survival was 67.5 months and the median overall survival was not reached. According to multivariable analysis, a ΔNLR≥0 was significantly associated with decreased progression-free survival (HR=2.91, 95% CI 1.43 to 5.94) and overall survival (HR=3.13, 95% CI 1.18 to 8.27). In addition, age (age <58.5 years; progression-free survival: HR=2.55, 95% CI 1.38 to 4.70; overall survival: HR=4.49, 95% CI 1.78 to 11.33) and the International Federation of Gynecology and Obstetrics (FIGO) stage (Ⅲ-Ⅳ; progression-free survival: HR=2.49, 95% CI 1.40 to 4.43; overall survival: HR=3.02, 95% CI 1.32 to 6.90) were identified as predictors of poor survival.ConclusionsBoth the age and FIGO stage, as clinical parameters, and the ΔNLR, as a hematologic parameter, were independent prognostic factors for survival for cervical cancer patients treated with chemoradiation. Based on these results, we developed a risk score-based classification system for predicting survival.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Qingduo Kong ◽  
Hongyi Wei ◽  
Jing Zhang ◽  
Yilin Li ◽  
Yongjun Wang

Abstract Background Laparoscopy has been widely used for patients with early-stage epithelial ovarian cancer (eEOC). However, there is limited evidence regarding whether survival outcomes of laparoscopy are equivalent to those of laparotomy among patients with eEOC. The result of survival outcomes of laparoscopy is still controversial. The aim of this meta-analysis is to analyze the survival outcomes of laparoscopy versus laparotomy in the treatment of eEOC. Methods According to the keywords, Pubmed, Embase, Cochrane Library and Clinicaltrials.gov were searched for studies from January 1994 to January 2021. Studies comparing the efficacy and safety of laparoscopy versus laparotomy for patients with eEOC were assessed for eligibility. Only studies including outcomes of overall survival (OS) were enrolled. The meta-analysis was performed using Stata software (Version 12.0) and Review Manager (Version 5.2). Results A total of 6 retrospective non-random studies were included in this meta-analysis. The pooled results indicated that there was no difference between two approaches for patients with eEOC in OS (HR = 0.6, P = 0.446), progression-free survival (PFS) (HR = 0.6, P = 0.137) and upstaging rate (OR = 1.18, P = 0.54). But the recurrence rate of laparoscopic surgery was lower than that of laparotomic surgery (OR = 0.48, P = 0.008). Conclusions Laparoscopy and laparotomy appear to provide comparable overall survival and progression-free survival outcomes for patients with eEOC. Further high-quality studies are needed to enhance this statement.


PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242173
Author(s):  
Benchao Chen ◽  
Heng Li ◽  
Chao Liu ◽  
Xudong Xiang ◽  
Shuting Wang ◽  
...  

Background Many previous studies have revealed that tumour-infiltrating lymphocytes (TILs) are significantly associated with prognosis in various tumours. However, this finding remains controversial in non-small cell lung cancer (NSCLC). We performed this meta-analysis systematically to evaluate the prognostic value of TILs in NSCLC. Methods The references were collected by searching the PubMed, EMBASE and Web of Science databases. The pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were summarized using random or fixed effects models to evaluate the association between TILs and NSCLC survival outcomes. Results A total of 45 interrelated studies were eligible that included 11,448 patients. Pooled analysis showed that a high density of TILs indicated a better overall survival (HR = 0.80, 0.70–0.89) and progression-free survival (HR = 0.73, 0.61–0.85) for patients with NSCLC; a high density of CD3+ TILs in the tumour nest indicated a better overall survival (HR = 0.84, 0.69–0.99) and disease-specific survival (HR = 0.57, 0.34–0.80); a high density of CD4+ TILs in the tumor nest indicated a favourable overall survival (HR = 0.86, 0.76–0.96); a high density of CD8+ TILs indicated a favourable overall survival (HR = 0.995, 0.99–1.0), progression-free survival (HR = 0.52, 0.34–0.71), disease-free survival (HR = 0.64, 0.43–0.85), relapse/recurrence-free survival (HR = 0.42, 0.18–0.67) and disease-specific survival (HR = 0.56, 0.35–0.78); and a high density of CD20+ TILs in the tumour nest indicated a favourable overall survival (HR = 0.65, 0.36–0.94). However, a high density of Foxp3+ TILs in the tumour stroma indicated a worse relapse/recurrence-free survival (HR = 1.90, 1.05–2.76) in NSCLC. Conclusions Our meta-analysis confirmed that high densities of TILs, CD3+TILs, CD4+TILs, CD8+TILs and CD20+TILs in the tumour nest are favourable prognostic biomarkers for patients with NSCLC, and Foxp3+TILs in the tumour stroma are a poor prognostic biomarker.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Pan Wang ◽  
Wei-sheng Xiao ◽  
Yue-hua Li ◽  
Xiao-ping Wu ◽  
Hong-bo Zhu ◽  
...  

Gastric cancer (GC) is still a vital malignant cancer across the world with unsatisfactory prognostic results. Matrilin-3 (MATN3) is a member of the extracellular matrix (ECM) protein family. The present research intends to explore the expression level of MATN3 in patients with GC and to explore the prognosis significance of MATN3. In this study, we observed that the MATN3 expression was remarkably upregulated in GC samples in contrast to noncancer samples. Clinical analyses unveiled that high MATN3 expression was related to age, tumor status, and clinical stages. Survival analyses unveiled that patients with high MATN3 expression displayed a poorer overall survival and progression-free survival than those with low MATN3 expression. The AUC of the relevant ROC curve for 1 year, 3 years, and 5 years of survival is 0.571, 0.596, and 0.720, separately. Multivariate assays revealed that MATN3 expression and stage were independent predictors of poor prognosis of GC patients. A meta-analysis unveiled that high MATN3 expression was tightly associated with better overall survival. Overall, our data indicated that MATN3 may have a diagnostic and prognostic value for patients with advanced gastric cancer and assist to improve clinical outcomes for GC patients.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Chun-Kai Liao ◽  
Yen-Lin Yu ◽  
Yueh-Chen Lin ◽  
Yu-Jen Hsu ◽  
Yih-Jong Chern ◽  
...  

Abstract Backgrounds The inflammatory biomarker “C-reactive protein to albumin ratio (CAR)” has been reported to significantly correlate to a variety of human cancers. However, there are conflicting results regarding the prognostic value of CAR in colorectal cancer. Previous studies mainly assessed patients in Eastern countries, so their findings may not be applicable to the Western population. Therefore, this updated meta-analysis aimed to investigate the prognostic value of pre-treatment CAR and outcomes of patients with colorectal cancer. Methods We conducted a systematic search for eligible literature until October 31, 2020, using PubMed and Embase databases. Studies assessing pre-treatment CAR and outcomes of colorectal cancer were included. Outcome measures included overall survival, disease-free survival, progression-free survival, and clinicopathological features. The pooled hazard ratios (HR) with 95% confidence intervals (CI) were used as effective values. Results A total of 15 studies involving 6329 patients were included in this study. The pooled results indicated that a high pre-treatment CAR was associated with poor overall survival (HR 2.028, 95% CI 1.808−2.275, p < 0.001) and poor disease-free survival/progression-free survival (HR 1.768, 95% CI 1.321–2.365, p < 0.001). Subgroup analysis revealed a constant prognostic value of the pre-treatment CAR despite different study regions, sample size, cancer stage, treatment methods, or the cut-off value used. We also noted a correlation between high pre-treatment CAR and old age, male sex, colon cancer, advanced stage (III/IV), large tumor size, poor differentiation, elevated carcinoembryonic antigen levels, neutrophil-to-lymphocyte ratio, and the modified Glasgow prognostic score. Conclusions High pre-treatment CAR was associated with poor overall survival, disease-free survival, and progression-free survival in colorectal cancer. It can serve as a prognostic marker for colorectal cancer in clinical practice.


Immunotherapy ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 785-798
Author(s):  
Adi Kartolo ◽  
Ryan Holstead ◽  
Sidra Khalid ◽  
Jeffrey Emack ◽  
Wilma Hopman ◽  
...  

Aim: To examine neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in prognosticating immunotherapy efficacy. Methods: A retrospective study of 156 patients with metastatic melanoma and non-small-cell lung cancer on PD-1 inhibitors. Results: Baseline NLR ≥5 was associated with worse progression-free survival (hazard ratio [HR]: 1.53; 95% CI: 1.01–2.31; p = 0.043) but nonsignificant worse overall survival trend (HR: 1.51; 95% CI: 0.98–2.34; p = 0.064). PLR ≥200 was associated with worse overall survival (HR: 1.94; 95% CI: 1.29–2.94; p = 0.002) and worse progression-free survival (HR: 1.894; 95% CI: 1.27–2.82; p = 0.002). NLR or PLR are prognosticating factors regardless of cancer types, with PLR having a stronger association with outcomes than NLR. Conclusion: High baseline NLR or PLR (alone and combined) were associated with worse immunotherapy efficacy regardless of cancer type, indicating their potential role as an agnostic marker for immunotherapy efficacy.


2021 ◽  
Vol 10 (10) ◽  
pp. 2199
Author(s):  
Jeong Won Lee ◽  
Ki Ho Seol

The aim of the study was to evaluate pretreatment neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as prognostic factors for predicting clinical outcomes after definitive concurrent chemoradiotherapy (CCRT) for cervical cancer. The cases were divided into two groups based on the values of NLR and PLR: High NLR-PLR (high value in both NLR and PLR) and Low NLR-PLR (low value in either NLR or PLR). The relationships between survival outcomes and the pretreatment NLR-PLR were investigated. Of the 148 patients enrolled in the study, 30 patients died during the median follow-up of 75 months. Based on receiver operating curves, NLR and PLR cut-off values for survival analysis were 2.34 and 148.89. The 10-year overall survival and disease-free survival rates for high NLR-PLR vs. low NLR-PLR were 63.6% vs. 86.2% (p = 0.001) and 63.3% vs. 77.5% (p = 0.026), respectively. Based on a multivariate analysis, independent predictors of overall survival were high NLR-PLR (hazard ratio [HR], 2.435; 95% confidence interval [CI], 1.106–5.361; p = 0.027) and stage (HR 2.659; 95% CI, 1.146–6.613; p = 0.024). Increases in both NLR and PLR are associated with poor survival. Elevation in both NLR and PLR before initiation of CCRT may be a useful biomarker for predicting clinical outcomes.


Cancers ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 1830
Author(s):  
Doo Yong Chung ◽  
Dong Hyuk Kang ◽  
Jong Won Kim ◽  
Do Kyung Kim ◽  
Joo Yong Lee ◽  
...  

Treatment-related adverse events (AEs) can obfuscate the maintenance of a conventional schedule of sunitinib in patients with metastatic renal cell carcinoma. Accordingly, alternative schedules seeking to improve the safety profile of sunitinib have been tested. Recently, two meta-analyses similarly described improved safety profiles favoring a two weeks on and one week off (2/1) schedule, but with conflicting results for survival outcomes. Therefore, we conducted an updated systematic review and meta-analysis, including all recently published studies and using complementary statistical methods. Endpoints included progression-free survival, overall survival, and AEs of 15 types. Eleven articles were included in this meta-analysis. Using adjusted findings, we noted statistically better results in progression-free survival (hazard ratio, 0.58; 95% confidence interval, 0.39–0.84; p = 0.005), but no difference in overall survival (hazard ratio, 0.66; 95% confidence interval, 0.42–1.04; p = 0.08). Moreover, the 2/1 schedule was beneficial for reducing the incidence of several AEs. Conclusively, our meta-analysis suggests that the 2/1 schedule holds promise as an alternative means of reducing AEs and maintaining patient quality of life. While the survival outcomes of the 2/1 schedule seem also to be favorable, the level of evidence for this was low, and the interpretation of these findings should warrant caution. Large scale randomized trials are needed to support these results.


Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 438
Author(s):  
Dong Liu ◽  
Zoltan Czigany ◽  
Lara R. Heij ◽  
Stefan A. W. Bouwense ◽  
Ronald van Dam ◽  
...  

The platelet-to-lymphocyte ratio (PLR), an inflammatory parameter, has shown prognostic value in several malignancies. The aim of this meta-analysis was to determine the impact of pretreatment PLR on the oncological outcome in patients with cholangiocarcinoma (CCA). A systematic literature search has been carried out in the PubMed and Google Scholar databases for pertinent papers published between January 2000 and August 2021. Within a random-effects model, the pooled hazard ratio (HR) and 95% confidence interval (CI) were calculated to investigate the relationships among the PLR, overall survival (OS), and disease-free survival (DFS). Subgroup analysis, sensitivity analysis, and publication bias were also conducted to further evaluate the relationship. A total of 20 articles comprising 5429 patients were included in this meta-analysis. Overall, the pooled outcomes revealed that a high PLR before treatment is associated with impaired OS (HR = 1.14; 95% CI = 1.06–1.24; p < 0.01) and DFS (HR = 1.57; 95% CI = 1.19–2.07; p < 0.01). Subgroup analysis revealed that this association is not influenced by the treatment modality (surgical vs. non-surgical), PLR cut-off values, or sample size of the included studies. An elevated pretreatment PLR is prognostic for the OS and DFS of CCA patients. More high-quality studies are required to investigate the pathophysiological basis of the observation and the prognostic value of the PLR in clinical management as well as for patient selection.


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