Prognostic Role of Platelet-to-Lymphocyte Ratio in Patients With Bladder Cancer: A Meta-Analysis.

Xingmu Wang,Xiaoyan Ni,Guiliang Tang

doi:10.3389/fonc.2019.00757

Xingmu Wang, Xiaoyan Ni + Show 1 more

Open Access

https://doi.org/10.3389/fonc.2019.00757

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Abstract

Background: Many studies have been reported that platelet-to-lymphocyte ratio (PLR) may be associated with the prognosis of bladder cancer, but the results are inconsistent. Therefore, we performed a meta-analysis to evaluate the effect of pretreatment PLR on the prognosis of bladder cancer.Methods: The databases PubMed, Embase, Cochrane Library, and Web of Science were searched. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were used to analyze the relationship between PLR and prognosis. Pooled odds ratios (ORs) and 95% CIs were used to analyze the relationship between PLR and clinicopathological features. Publication bias was estimated using Begg's funnel plot asymmetry tests.Results: A total of 8 studies comprising 3,303 patients were included in this meta-analysis. An elevated PLR was significantly associated with poorer overall survival (OS) (HR = 1.26, 95% CI = 1.03–1.54, p = 0.026), but not with cancer-specific survival (CSS) (HR = 1.15, 95% CI = 0.95–1.38, p = 0.149), or recurrence-free survival (RFS) (HR = 1.72, 95% CI = 0.79–3.75, p = 0.175). In addition, high PLR was correlated with age ≥ 65 years (OR = 1.82, 95% CI = 1.24–2.67, p = 0.002), whereas was not significantly correlated with sex, tumor grade, tumor stage, distant metastasis, or tumor size.Conclusions: The pretreatment PLR could serve as a predicative biomarker of poor prognosis for patients with bladder cancer.

Highlights

Bladder cancer is the 10th most common cancer worldwide, with an estimated 549,000 new cases and 200,000 deaths in 2018 [1]
An elevated platelet-to-lymphocyte ratio (PLR) was significantly associated with poorer overall survival (OS) (HR = 1.26, 95% confidence intervals (CIs) = 1.03–1.54, p = 0.026), but not with cancer-specific survival (CSS) (HR = 1.15, 95% CI = 0.95–1.38, p = 0.149), or recurrence-free survival (RFS) (HR = 1.72, 95% CI = 0.79–3.75, p = 0.175)
High PLR was correlated with age ≥ 65 years (OR = 1.82, 95% CI = 1.24–2.67, p = 0.002), whereas was not significantly correlated with sex, tumor grade, tumor stage, distant metastasis, or tumor size

Summary

Introduction

Bladder cancer is the 10th most common cancer worldwide, with an estimated 549,000 new cases and 200,000 deaths in 2018 [1]. 75% of all bladder cancer cases occur in men and incidence rates varies largely around the world [1]. Bladder carcinomas are classified as non-muscle invasive bladder cancer (NMIBC) (Ta/T1) and muscle-invasive bladder cancer (MIBC) (T2–T4). Despite aggressive surgical treatment and improvements in therapeutic approaches for bladder cancer, survival outcome has not substantially improved, with high recurrence and mortality [3]. Many studies have been reported that platelet-to-lymphocyte ratio (PLR) may be associated with the prognosis of bladder cancer, but the results are inconsistent. We performed a meta-analysis to evaluate the effect of pretreatment PLR on the prognosis of bladder cancer

Methods

Results

Conclusion