Abstract
Introduction Pretreatment platelet-to-lymphocyte ratio (PLR) has been considered a prognostic factor in various cancers. However, the application of PLR in the assessment of patients with cholangiocarcinoma remains controversial. This study aimed to evaluate the prognostic value of pretreatment PLR in cholangiocarcinoma. Methods A systematic search was performed in MEDLINE, EMBASE, and Cochrane Library to identify studies assessing the prognostic significance of the pretreatment PLR in cholangiocarcinoma. Three databases were searched from inception to August 5, 2018. The primary outcome was overall survival (OS), and the secondary outcomes were recurrence-free survival (RFS) and progression-free survival (PFS). Pooled hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. Results A total of 9 studies including 2395 patients were finally enrolled in the meta-analysis based on the inclusion and exclusion criteria. All of the included studies were retrospective observational cohorts. Elevated PLR predicted poor OS (HR: 1.38, 95% CI: 1.19-1.62, P < 0.001) and RFS or PFS (HR = 1.55; 95% CI = 1.27-1.88; P < 0.001). Moreover, elevated PLR was highly associated with male sex (male versus female OR = 0.59, 95% CI: 0.44-0.80, P < 0.001) and R1 resection margin (OR = 2.09, 95% CI: 1.24-3.54, P = 0.006). Conclusion The present meta-analysis demonstrated that pretreatment PLR might serve as a useful prognostic biomarker in cholangiocarcinoma.
Highlights
Pretreatment platelet-to-lymphocyte ratio (PLR) has been considered a prognostic factor in various cancers
As shown in the flow diagram (Figure 1), 111 potentially relevant articles were obtained through electronic searches. 99 articles remained after exclusion of duplicated data
Of the 9 studies, four studies were from China, three were from Japan, one was from Korea, and one was from multiple centers
Summary
Pretreatment platelet-to-lymphocyte ratio (PLR) has been considered a prognostic factor in various cancers. This study aimed to evaluate the prognostic value of pretreatment PLR in cholangiocarcinoma. A systematic search was performed in MEDLINE, EMBASE, and Cochrane Library to identify studies assessing the prognostic significance of the pretreatment PLR in cholangiocarcinoma. The present meta-analysis demonstrated that pretreatment PLR might serve as a useful prognostic biomarker in cholangiocarcinoma. An increasing incidence of CCA has been reported over the last few decades [2] It is the second most frequent type of primary liver cancer and comprises malignancies with high inter- and intratumor heterogeneities. It is currently classified into intrahepatic, perihilar, and distal extrahepatic cholangiocarcinoma [3]. A reliable and readily accessible preoperative prognostic biomarker is required to determine the optimal therapeutic strategies
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