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Prognostic role of pretreatment blood neutrophil-to-lymphocyte ratio in advanced cancer survivors: A systematic review and meta-analysis of 66 cohort studies.
Cancer Treat Rev. 2017 May 29;58:1-13
Authors: Mei Z, Shi L, Wang B, Yang J, Xiao Z, Du P, Wang Q, Yang W
Abstract
BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) is crucial for the incidence and mortality of various tumors. However, little is known on NLR and its association with prognosis in advanced tumors. Here we performed a meta-analysis to establish the prognostic significance of pretreatment blood NLR for advanced tumors.
METHODS: A systematic literature search through April 2016 was performed to evaluate the association between pretreatment blood NLR and overall survival (OS) or progression-free survival (PFS) in patients with advanced tumors. Data were extracted from studies reporting hazard ratios (HRs) and 95% confidence interval (CI) and pooled using the Mantel-Haenszel random-effect model.
RESULTS: Sixty-six studies with a total of 24536 individuals were included in the meta-analysis. Pooled analyses revealed that elevated pretreatment NLR was associated with worse OS (HR 1.70, 95% CI 1.57-1.84, P<0.001) and PFS (HR 1.61, 95% CI 1.42-1.82, P<0.001) in advanced tumors. Subgroup analysis stratified by tumor type demonstrated that pancreatic cancer patients with high pretreatment NLR had the worst OS (HR 1.94, 95% CI 1.55-2.54, P<0.001) and colorectal cancer with the worst PFS (HR 1.74, 95% CI 1.04-2.90, P<0.001). When stratified by cut-off value for NLR, we found that cut-off value being five indicated the worst PFS (HR 2.23, 95% CI 1.54-3.23, P=0.019).
CONCLUSIONS: Overall, high pretreatment blood NLR could be an adverse prognostic indicator for advanced tumor. Large-scale prospective studies investigating its survival outcomes in specific cancer type are strongly advocated.
PMID: 28602879 [PubMed - as supplied by publisher]
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