Prognostic Significance of Platelet-to-Lymphocyte Ratio in Cholangiocarcinoma: A Meta-Analysis

Introduction. Pretreatment platelet-to-lymphocyte ratio (PLR) has been considered a prognostic factor in various cancers. However, the application of PLR in the assessment of patients with cholangiocarcinoma remains controversial. This study aimed to evaluate the prognostic value of pretreatment PLR in cholangiocarcinoma. Methods. A systematic search was performed in MEDLINE, EMBASE, and Cochrane Library to identify studies assessing the prognostic significance of the pretreatment PLR in cholangiocarcinoma. Three databases were searched from inception to August 5, 2018. The primary outcome was overall survival (OS), and the secondary outcomes were recurrence-free survival (RFS) and progression-free survival (PFS). Pooled hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. Results. A total of 9 studies including 2395 patients were finally enrolled in the meta-analysis based on the inclusion and exclusion criteria. All of the included studies were retrospective observational cohorts. Elevated PLR predicted poor OS (HR: 1.38, 95% CI: 1.19-1.62, P < 0.001) and RFS or PFS (HR = 1.55; 95% CI = 1.27-1.88; P < 0.001). Moreover, elevated PLR was highly associated with male sex (male versus female OR = 0.59, 95% CI: 0.44-0.80, P < 0.001) and R1 resection margin (OR = 2.09, 95% CI: 1.24-3.54, P = 0.006). Conclusion. The present meta-analysis demonstrated that pretreatment PLR might serve as a useful prognostic biomarker in cholangiocarcinoma.

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Prognostic significance of platelet-to-lymphocyte ratio in urothelial carcinoma patients: a meta-analysis

Cancer Cell International ◽

10.1186/s12935-019-1032-6 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Yuhai Bao ◽

Yin Wang ◽

Xiaodong Li ◽

Mingjun Pan ◽

Hongze Zhang ◽

...

Keyword(s):

Urothelial Carcinoma ◽

Meta Analysis ◽

Prognostic Significance ◽

Disease Free Survival ◽

Cochrane Library ◽

Prognostic Impact ◽

Platelet To Lymphocyte Ratio ◽

Cancer Specific Survival ◽

Free Survival ◽

Lymphocyte Ratio

Abstract Background The prognostic value of pre-treatment platelet-to-lymphocyte ratio (PLR) in patients with urothelial carcinoma (UC) remains controversial. Therefore, this meta-analysis aimed to identify the prognostic impact of PLR on UC. Methods The PubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched. Hazard ratios (HRs) with 95% confidence intervals (CIs) were used to summarize the correlations between PLR and overall survival (OS), progression-free survival (PFS), disease-free survival (DFS), and cancer-specific survival (CSS). Odds ratios (ORs) with 95% CIs were used to measure the association between PLR and tumor clinicopathological factors. Results The meta-analysis included 15 studies published from 2015 to 2019 with a total of 5354 patients. Overall, a high PLR was correlated to poorer PFS (HR = 1.81, 95% CI 1.28–2.56, p = 0.001) and DFS (HR = 1.09, 95% CI 1.31–2.16, p < 0.001) but not poor OS (HR = 1.23, 95% CI 0.95–1.59, p = 0.124) or CSS (HR = 1.000, 95% CI 0.998–1.002, p = 0.919) in UC. In addition, an elevated PLR was correlated with patient age > 65 years (OR = 1.72, 95% CI 1.25–2.38, p = 0.001) and hypertension (OR = 1.48, 95% CI 1.01–2.18, p = 0.046). However, no significant association was observed between PLR and sex (OR = 0.79, 95% CI 0.56–1.14, p = 0.206) or diabetes (OR = 1.29, 95% CI 0.77–2.15, p = 0.333). Conclusions Our results demonstrated a significant correlation between elevated PLR and poor prognosis in UC. The prognostic role of PLR may help guide the management and prognostication of UC patients.

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Neutrophil-to-Lymphocyte Ratio Is a Potential Prognostic Biomarker in Patients with Ovarian Cancer: A Meta-Analysis

BioMed Research International ◽

10.1155/2017/7943467 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Shubo Chen ◽

Liu Zhang ◽

Guangyue Yan ◽

Sijin Cheng ◽

Abdel Hamid Fathy ◽

...

Keyword(s):

Ovarian Cancer ◽

Prognostic Biomarker ◽

Meta Analysis ◽

Prognostic Significance ◽

Progression Free Survival ◽

Neutrophil To Lymphocyte Ratio ◽

Cochrane Library ◽

Free Survival ◽

Lymphocyte Ratio ◽

Asian People

Background and Aims. Plenty of studies were conducted to explore the prognostic significance of neutrophil-to-lymphocyte ratio (NLR) in ovarian cancer with contradictory results. This study aims to summarize the prognostic significance of NLR in patients with ovarian cancer. Methods. A literature search in PubMed, Cochrane Library, and Embase was conducted. The endpoints were progression-free survival (PFS) and overall survival (OS). Results. Eleven studies involving a total of 2,892 patients were identified. The results indicated that patients with high NLR had shorter PFS compared to patients with low NLR in ovarian cancer (HR = 1.55, 95% CI = 1.15–2.08, p=0.004, and I2=61%). Similarly, high NLR was related to shorter OS (HR = 1.51, 95% CI = 1.03–2.23, p=0.04, and I2=85%). Moreover, high NLR was significantly associated with shorter PFS when the NLR cut-off was less than 3.3 (p=0.03) or when treatment is operation (p=0.002). In addition, high NLR was distinctly related to worse OS in Asian people (p = 0.04) or operation (p = 0.04). Conclusion. High NLR was associated with shorter PFS and shorter OS in ovarian cancer. NLR is potentially a promising prognostic biomarker in patients with ovarian cancer.

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Prognostic significance of platelet-to-lymphocyte ratio in patients with nasopharyngeal carcinoma: a meta-analysis

Future Oncology ◽

10.2217/fon-2019-0520 ◽

2020 ◽

Vol 16 (5) ◽

pp. 117-127 ◽

Cited By ~ 2

Author(s):

Junkai Zhang ◽

Weineng Feng ◽

Zhihua Ye ◽

Ying Wei ◽

Lamei Li ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Meta Analysis ◽

Prognostic Significance ◽

Intensity Modulated Radiotherapy ◽

Progression Free Survival ◽

Platelet To Lymphocyte Ratio ◽

Poor Overall Survival ◽

Free Survival ◽

Lymphocyte Ratio ◽

N Stage

Aim: Several studies reported the association of platelet-to-lymphocyte ratio (PLR) and prognosis in nasopharyngeal carcinoma (NPC), but the results remain controversial. Therefore, we investigated the prognostic value of PLR in NPC through meta-analysis. Materials & methods: A comprehensive literature search of PubMed, Embase and Web of Science was performed. Results: A total of 9 studies comprising of 3459 patients with NPC were included. The data demonstrated that an increased PLR predicted poor overall survival, progression-free survival and distant metastasis-free survival. There was no significant association between PLR and sex, age, T stage, N stage, tumor node metastasis (TNM) stage or intensity-modulated radiotherapy. Conclusion: This meta-analysis revealed that PLR might be a potential predicative biomarker of poor prognosis in patients with NPC.

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The Prognostic Significance of Combined Pretreatment Fibrinogen and Neutrophil-Lymphocyte Ratio in Various Cancers: A Systematic Review and Meta-Analysis

Disease Markers ◽

10.1155/2020/4565379 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Rongqiang Liu ◽

Shiyang Zheng ◽

Qing Yuan ◽

Peiwen Zhu ◽

Biao Li ◽

...

Keyword(s):

Prognostic Value ◽

Meta Analysis ◽

Prognostic Significance ◽

Disease Free Survival ◽

Progression Free Survival ◽

Regression Analyses ◽

Free Survival ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Meta Regression

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.

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Survival of Patients Treated with Antibiotics and Immunotherapy for Cancer: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm9051458 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1458 ◽

Cited By ~ 1

Author(s):

Fausto Petrelli ◽

Alessandro Iaculli ◽

Diego Signorelli ◽

Antonio Ghidini ◽

Lorenzo Dottorini ◽

...

Keyword(s):

Cancer Patients ◽

Checkpoint Inhibitors ◽

Meta Analysis ◽

Progression Free Survival ◽

Cochrane Library ◽

Free Survival ◽

Patients With Cancer ◽

Hazard Ratios ◽

The Cochrane Library ◽

Reporting Data

Antibiotics (ABs) are common medications used for treating infections. In cancer patients treated with immune checkpoint inhibitors (ICIs), concomitant exposure to ABs may impair the efficacy of ICIs and lead to a poorer outcome compared to AB non-users. We report here the results of a meta-analysis evaluating the effects of ABs on the outcome of patients with solid tumours treated with ICIs. PubMed, the Cochrane Library and Embase were searched from inception until September 2019 for observational or prospective studies reporting the prognoses of adult patients with cancer treated with ICIs and with or without ABs. Overall survival (OS) was the primary endpoint, and progression-free survival (PFS) was the secondary endpoint. The effect size was reported as hazard ratios (HRs) with a 95% confidence interval (CI) and an HR > 1 associated with a worse outcome in ABs users compared to AB non-users. Fifteen publications were retrieved for a total of 2363 patients. In the main analysis (n = 15 studies reporting data), OS was reduced in patients exposed to ABs before or during treatment with ICIs (HR = 2.07, 95%CI 1.51–2.84; p < 0.01). Similarly, PFS was inferior in AB users in n = 13 studies with data available (HR = 1.53, 95%CI 1.22–1.93; p < 0.01). In cancer patients treated with ICIs, AB use significantly reduced OS and PFS. Short duration/course of ABs may be considered in clinical situations in which they are strictly needed.

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The Prognostic Roles and Clinical Features of CD44v9 in Human Solid Cancers—A Meta-Analysis

10.21203/rs.3.rs-54020/v1 ◽

2020 ◽

Author(s):

Yuanxiu Deng ◽

Jie Wang ◽

Shenhui Ji ◽

Lu Huang ◽

Meijiang Feng

Keyword(s):

Clinical Features ◽

Meta Analysis ◽

Prognostic Significance ◽

Disease Free Survival ◽

Progression Free Survival ◽

High Expression ◽

Cochrane Library ◽

Cancer Specific Survival ◽

Free Survival ◽

Diagnosis And Prognosis

Abstract Background: CD44 is the primary receptor for hyaluronic acid and serves as a marker for cancer stem cells. CD44v9 is one of CD44’s variants and takes part in cancer’s growth and metastasis. However, the prognostic roles and clinical features of CD44v9 in cancers remain unclear. Therefore, we conducted this meta-analysis to summarize the prognostic significance and clinical features of CD44v9 in human solid cancers.Methods: we systematically searched all of related studies in PubMed, the Web of Science, Embase and Cochrane library up to June 2020. We analyzed the pooled hazard ratios (HRs) and odds ratios (ORs) with corresponding 95% confidence intervals (CIs) to assess the prognostic functions and clinical features of CD44v9 in various human solid cancers.Results: In this meta-analysis, we included 1705 cancer patients among 12 studies. Results indicated that high expression of CD44v9 was significantly related to poorer overall survival (OS) (HR=1.60, 95%CI 1.28-1.99, P<0.0001), recurrence-free survival/progression-free survival/disease-free survival (RFS/PFS/DFS).( HR=1.81, 95%CI 1.16-2.84, P=0.009) and disease-specific survival/cancer-specific survival (DSS/CSS) (HR=2.93, 95%CI 1.69-5.10, P<0.001). At the same time, we also found that high expression of CD44v9 increased the possibility of lymphoid infiltrates (OR=1.59, 95%CI 1.16-2.20, P=0.005), vascular invasion (OR=1.57, 95%CI 1.11-2.22, P=0.010) and higher TNM stage (OR=1.63, 95%CI 1.19-2.23, P=0.002).Conclusion: Our results demonstrate that CD44v9 overexpression is associated with worse OS, RFS/PFS/CFS and DSS/CSS in patients with solid cancers, which might be a biomarker in the diagnosis and prognosis of cancers in the future.

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Survival of Patients Treated with Antibiotics and Immunotherapy for Cancer: A Systematic Review and Meta-Analysis

10.20944/preprints202003.0425.v1 ◽

2020 ◽

Author(s):

Fausto Petrelli ◽

Alessandro Iaculli ◽

Diego Signorelli ◽

Antonio Ghidini ◽

Lorenzo Dottorini ◽

...

Keyword(s):

Cancer Patients ◽

Checkpoint Inhibitors ◽

Meta Analysis ◽

Progression Free Survival ◽

Cochrane Library ◽

Free Survival ◽

Patients With Cancer ◽

Hazard Ratios ◽

The Cochrane Library ◽

Reporting Data

Antibiotics (ABs) are common medications used for treating infections. In cancer patients treated with immune checkpoint inhibitors (ICIs), concomitant exposure to ABs may impair the efficacy of ICIs and lead to a poorer outcome compared to AB non-users. We report here the results of a meta-analysis evaluating the effects of ABs on the outcome of patients with solid tumors treated with ICIs. PubMed, the Cochrane Library, and Embase were searched from inception until September 2019 for observational or prospective studies reporting prognosis of adult patients with cancer treated with ICIs and with or without ABs. Overall survival (OS) was the primary endpoint, and progression-free survival (PFS) was the secondary endpoint. The effect size was reported as hazard ratios (HRs) with a 95% confidence interval (CI), and an HR > 1 associated with a worse outcome in ABs users compared to no-ABs users. Fifteen publications were retrieved for a total of 2363 patients. In the main analysis (n = 15 studies reporting data), OS was reduced in patients exposed to ABs before or during treatment with ICIs (HR = 2.07, 95%CI 1.51–2.84; P<.01). Similarly, PFS was inferior in ABs users in n = 13 studies with data available (HR = 1.53, 95%CI 1.22–1.93; p<.01). In cancer patients treated with ICIs, AB use significantly reduces OS and PFS. Short duration/course of ABs may be considered in clinical situations in which they are strictly needed.

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

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2018-000090 ◽

2019 ◽

Vol 29 (4) ◽

pp. 683-690 ◽

Cited By ~ 4

Author(s):

Lixiao Yang ◽

Huixiao Chen

Keyword(s):

Cervical Cancer ◽

Overall Survival ◽

Prognostic Value ◽

Meta Analysis ◽

Progression Free Survival ◽

Survival Outcomes ◽

Platelet To Lymphocyte Ratio ◽

Free Survival ◽

Lymphocyte Ratio ◽

Meta Regression

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.

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Prognostic and Clinicopathological Significance of PD-L1 in Patients with Cholangiocarcinoma: A Meta-Analysis

Disease Markers ◽

10.1155/2020/1817931 ◽

2020 ◽

Vol 2020 ◽

pp. 1-12

Author(s):

Qinfen Xie ◽

Lidong Wang ◽

Shusen Zheng

Keyword(s):

Meta Analysis ◽

Prognostic Significance ◽

Disease Free Survival ◽

Cochrane Library ◽

Free Survival ◽

Hazard Ratios ◽

Programmed Death ◽

Poor Differentiation ◽

Clinicopathological Significance ◽

Pn Stage

Background. In recent years, there is growing literature on the prognostic significance of programmed death-ligand 1 (PD-L1) in cholangiocarcinoma (CCA); however, data have been conflicting. Therefore, the objective of this study was to assess the correlation between PD-L1 and prognosis in CCA through meta-analysis. Methods. Published studies were retrieved from the Web of Science, PubMed, Embase, and Cochrane Library up to April 17, 2020. The relationships between PD-L1 expression and survival outcomes were assessed using hazard ratios (HRs) and 95% confidence intervals (CIs). Results. Eighteen studies consisting of 2012 patients were included. Overexpression of PD-L1 was significantly associated with worse overall survival (OS) (HR=1.58, 95%CI=1.30−1.92, p<0.001) but not with poor disease-free survival (DFS) (HR=1.03, 95%CI=0.68−1.55, p=0.895) in CCA. Moreover, PD-L1 was associated with low differentiation (OR=1.43, 95%CI=1.09−1.87, p=0.010) and higher pN stage (OR=1.45, 95%CI=1.10−1.92, p=0.009) but not with sex, TNM stage, vascular invasion, perineural invasion, age, or tumor size. Conclusion. High PD-L1 expression was associated with worse OS, poor differentiation, and higher pN stage in patients with CCA. PD-L1 could be a potential prognostic marker in CCA.

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Prognostic and clinicopathological value of Ki-67 expression in patients with nasopharyngeal carcinoma: a meta-analysis

Therapeutic Advances in Medical Oncology ◽

10.1177/1758835920951346 ◽

2020 ◽

Vol 12 ◽

pp. 175883592095134

Author(s):

Zhaohui Shi ◽

Weihong Jiang ◽

Xiaodong Chen ◽

Min Xu ◽

Xiaocheng Wang ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Meta Analysis ◽

Progression Free Survival ◽

Cochrane Library ◽

Poor Overall Survival ◽

Ki 67 ◽

Free Survival ◽

Hazard Ratios ◽

N Stage

Background: This meta-analysis aimed to identify the prognostic role of Ki-67 in patients with nasopharyngeal carcinoma (NPC). Methods: Relevant studies were retrieved in the PubMed, Embase, Web of Science, and Cochrane Library databases up to November 2019. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to estimate the association between Ki-67 expression and survival outcomes. Combined odds ratios (ORs) and 95% CIs were measured as effect size on the association between Ki-67 expression and clinical factors. Results: A total of eight studies involving 936 patients with NPC were included in this meta-analysis. The pooled HR indicated that Ki-67 expression was significantly associated with poor overall survival (HR = 2.86, 95% CI = 1.91–4.27, p < 0.001), progression-free survival (HR = 1.78, 95% CI = 1.15–2.74, p = 0.009), and distant metastasis-free survival (HR = 1.65, 95% CI = 1.15–2.36, p = 0.007). However, there was no significant correlation between Ki-67 expression and local recurrence-free survival (HR = 1.07, 95% CI = 0.54–2.14, p = 0.843). Ki-67 overexpression was associated with higher T stage (OR = 1.48, 95% CI = 1.00–2.20, p = 0.052), and the relationship between Ki-67 expression and advanced stage was nearly significant (OR = 2.25, 95% CI = 0.99–5.14, p = 0.054). However, high Ki-67 expression was not significantly correlated with sex, age, N stage, or histological type. Conclusion: This meta-analysis demonstrated that Ki-67 overexpression was a significant marker for poor prognosis in patients with NPC. Ki-67 should be recommended as a useful index for prognostication in patients with NPC.

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