Abstract
The prognostic value of platelet to lymphocyte ratio (PLR) in urologic cancer does not reach a consensus. Herein, we performed the meta-analysis to determine the prognostic role of PLR in patients with urologic cancer. A literature search was performed in the PubMed, Embase, and Web of Science databases. Hazard ratios (HRs) were extracted to estimate the association between PLR and prognosis. A total of 20 articles comprising 6079 patients were included in this study. The pooled results showed that a high PLR was significantly associated with worse prognosis of overall survival (OS) in urologic cancer [HR=1.65, 95% confidence interval (CI) =1.37-1.99, P<0.01]. The result also indicated that an elevated PLR was significantly associated with poor OS in renal cancer (HR=1.88, 95% CI=1.39-2.55, P<0.01). In addition, the significant association between poor OS and elevated PLR in renal cancer was consistent regardless of treatment, cut-off value, sample size and study quality. Our result also indicated that an elevated PLR predicted shorter OS (HR=1.78, 95% CI=1.38-2.30, P<0.01) and cancer-specific survival (HR=2.02, 95% CI=1.24-3.29, P<0.01) in prostate cancer. In conclusion, an elevated PLR was a predictive indicator of poor survival in renal cancer and prostate cancer.
Highlights
Urologic cancer is one of the most common of cancers worldwide, with an estimated incidence of 146,650 new cases and 32,190 deaths in United States in 2017 [1]
Our result indicated that an elevated platelet to lymphocyte ratio (PLR) predicted shorter overall survival (OS) (HR=1.78, 95% confidence interval (CI)=1.38-2.30, P
Two studies assessed the relationship between PLR and OS, cancer-specific survival (CSS), while another two reported the association between PLR and disease-free survival (DFS) in patients with upper tract urothelial cancer (UTUC). These results indicated that a high PLR was significantly correlated with poor OS (HR=1.69, 95% CI=1.16-2.48, P
Summary
Urologic cancer is one of the most common of cancers worldwide, with an estimated incidence of 146,650 new cases and 32,190 deaths in United States in 2017 [1]. Urologic cancer patients with the same TNM stage may have different clinical prognosis [2]. This leaves a large space for the development of additional biomarkers to predict the clinical outcome. More and more evidence have reported that the development and prognosis of cancer are affected by cancer characteristics and by host systemic inflammatory response [3, 4]. The inflammatory response can be evaluated by lots of biomarkers such as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and C-reactive protein, etc.[5]. To the best of our knowledge, until now there was no a pooled study to assess the prognostic significance of PLR in urologic cancer
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