Abstract
Increasing evidence indicates that the neutrophil to lymphocyte ratio (NLR) is a useful biomarker of long-term outcomes in patients with cholangiocarcinoma. However, the prognostic role of NLR in patients with cholangiocarcinoma remains unclear. Thus, the current meta-analysis was undertaken to clarify the correlation between NLR and overall survival (OS) in cholangiocarcinoma, and a comprehensive literature research was conducted to understand the association of NLR and prognosis of cholangiocarcinoma. The hazard ratio (HR) with 95% confidence interval (CI) was used to assess OS. The synthesized HR of 1.449 (95% CI: 1.296–1.619, P < 0.001) indicated that a high NLR had an unfavourable effect on OS. Overall, this meta-analysis suggested that elevated preoperative NLR is associated with poorer rates of survival in cholangiocarcinoma patients.
Highlights
The incidence and mortality rates of the malignant tumour cholangiocarcinoma (CCA) are increasing worldwide[1,2], with approximately 5000 CCA-related deaths occurring per year[3]
On performing subgroup analyses stratified by cut-off value, we found that increased neutrophil to lymphocyte ratio (NLR) was a negative predictor for patients with cut-off values ≥4 (HR = 1.724, 95% confidence interval (CI): 1.215–2.233) and cut-off value
The meta-analysis conducted in the present study on 12 studies with a total of 2093 patients with CCA demonstrated that a high NLR is associated with significantly poor overall survival (OS)
Summary
The incidence and mortality rates of the malignant tumour cholangiocarcinoma (CCA) are increasing worldwide[1,2], with approximately 5000 CCA-related deaths occurring per year[3]. Patients undergo curative-intent surgery or adjuvant therapies including systemic chemotherapy and radiotherapy for palliation of CCA, their clinical outcomes remain poor[4]. Several trials have shown that clinicopathological factors including tumour size[5,6], intrahepatic satellite lesions[6,7], lymph node metastasis[8], vascular invasion[6] and resection margin involvement are associated with poor survival[9]. Published evidence suggests that systemic inflammation is related to poor survival in patients with various types of malignancies[10,11,12]. The neutrophil to lymphocyte ratio (NLR) is one of the inflammatory parameters that has been reported to be of prognostic value for some solid tumours, including CCA13,14. A meta-analysis to estimate the prognostic value of NLR in these patient groups is of significance
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