Abstract
Background and AimsSeveral studies were conducted to explore the prognostic significance of platelet to lymphocyte ratio (PLR) in hepatocellular carcinoma (HCC), however, contradictory results across most reports were documented. To this end, we present a systematic review that aims to summarize the prognostic significance of PLR in patients with HCC.ResultsA total of 10 studies involving a total of 2,315 patients were identified. The Newcastle-Ottawa Quality Assessment Scale (NOS) of each included study was greater than or equal to 5. The results indicated that high PLR was significantly associated with a worse OS when compared to the low PLR (HR = 1.60, 95% CI = 1.23−2.08, p = 0.0005; I2 = 88%, p < 0.00001). Similar results were detected in the subgroup analysis of the analysis model, cut-off value, ethnicity, sample size and therapy. However, no obvious correlation between the PLR and DFS/RFS in patients with HCC was observed (HR = 1.21, 95% CI = 0.87−1.67, p = 0.26; I2 = 61%, p = 0.07).Materials and MethodsA complete literature search in the PubMed, Cochrane Library and Embase database was performed. Retrospective and prospective studies focusing on the role of PLR on the prognosis in HCC were all deemed as “suitable” for our scope. The endpoints determined were: the overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS) and the progress free survival (PFS).ConclusionsThe study revealed that high PLR is an unfavorable predictor of OS in patients with HCC, and high PLR is a promising prognostic biomarker for HCC, especially for patients in Asia.
Highlights
hepatocellular carcinoma (HCC) is a principal health problem all over the world
The study revealed that high platelet to lymphocyte ratio (PLR) is an unfavorable predictor of overall survival (OS) in patients with HCC, and high PLR is a promising prognostic biomarker for HCC, especially for patients in Asia
For the 39 remaining potentially related studies, the full-text was carefully read. 16 were excluded for insufficient datum to assess the hazard ratio (HR) of prognosis outcomes, and 7 were excluded for not focusing on this topic, and 1 was excluded because the included patients were all covered by the study conducted by Kaprio et al, which published in the BMC cancer
Summary
HCC is a principal health problem all over the world. It is estimated that there were 782,500 new liver cancer cases and 745,500 deaths occurred worldwide during 2012 [1]. As for HCC, the study conducted by Fan et al supported that high PLR was an unfavorable factor on the prognosis and associated with shorter OS when compared to the low PLR [19]. Several studies were conducted to explore the prognostic significance of platelet to lymphocyte ratio (PLR) in hepatocellular carcinoma (HCC), contradictory results across most reports were documented. To this end, we present a systematic review that aims to summarize the prognostic significance of PLR in patients with HCC
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