Abstract
Background: Recent studies show that various inflammatory markers can have prognostic role in patients with resectable pancreatic cancer. While there are systematic reviews and meta-analyses analyzing importance of other blood markers, prognostic value of preoperative platelet to lymphocyte ratio (PLR) is still controversial. Our aim was to perform systematic review and meta-analysis of PLR as a preoperative prognostic factor for resectable PC. Material & Methods: Systematic literature search of PubMed, Cochrane and Lippincott Williams & Wilkins databases was conducted for studies, assessing PLR influence as a preoperative prognostic factor in resectable PC patients. Random effects model was used for pooling hazard ratios (HRs) and 95% confidence intervals (CIs) related to overall survival (OS) and disease-free survival. Results: A total of 102 publications were analyzed and 14 articles with 2743 patients were included in our study. The analysis showed that high PLR had no correlation with decreased OS (HR=1.00; 95% CI”Š=“Š0.99-1.01; P=0.39; I2=83%). Due to high heterogeneity between selected studies subgroup analysis was performed: high PLR was not associated with decreased OS in Caucasian patients (HR=1.00; 95% CI”Š=“Š1.00-1.01; P=0.76), patients with pancreaticoduodenectomy performed (HR=1.02; 95% CI”Š=“Š0.90-1.15; P=0.79), or patients with preoperative PLR >150 (HR=1.00; 95% CI=“Š1.00-1.01; P=0.64). However, better OS was associated with low PLR in Asian patients (HR=1.53; 95% CI=1.17-2.00; P=0.002) and in patients with preoperative PLR<150 (HR=1.32; 95% CI=1.04-1.68; P=0.02). Low PLR was associated with significantly better disease-free-survival (HR=1.60; 95% CI”Š=“Š1.03-2.49; P=0.04). Conclusions: Platelet to lymphocyte ratio is not a reliable overall survival prognostic factor in patients with resectable pancreatic cancer. However, low PLR might be a predictive factor of better disease-free survival.
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