Abstract
BackgroundThe prognostic value of pre-treatment platelet-to-lymphocyte ratio (PLR) in patients with urothelial carcinoma (UC) remains controversial. Therefore, this meta-analysis aimed to identify the prognostic impact of PLR on UC.MethodsThe PubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched. Hazard ratios (HRs) with 95% confidence intervals (CIs) were used to summarize the correlations between PLR and overall survival (OS), progression-free survival (PFS), disease-free survival (DFS), and cancer-specific survival (CSS). Odds ratios (ORs) with 95% CIs were used to measure the association between PLR and tumor clinicopathological factors.ResultsThe meta-analysis included 15 studies published from 2015 to 2019 with a total of 5354 patients. Overall, a high PLR was correlated to poorer PFS (HR = 1.81, 95% CI 1.28–2.56, p = 0.001) and DFS (HR = 1.09, 95% CI 1.31–2.16, p < 0.001) but not poor OS (HR = 1.23, 95% CI 0.95–1.59, p = 0.124) or CSS (HR = 1.000, 95% CI 0.998–1.002, p = 0.919) in UC. In addition, an elevated PLR was correlated with patient age > 65 years (OR = 1.72, 95% CI 1.25–2.38, p = 0.001) and hypertension (OR = 1.48, 95% CI 1.01–2.18, p = 0.046). However, no significant association was observed between PLR and sex (OR = 0.79, 95% CI 0.56–1.14, p = 0.206) or diabetes (OR = 1.29, 95% CI 0.77–2.15, p = 0.333).ConclusionsOur results demonstrated a significant correlation between elevated PLR and poor prognosis in UC. The prognostic role of PLR may help guide the management and prognostication of UC patients.
Highlights
The prognostic value of pre-treatment platelet-to-lymphocyte ratio (PLR) in patients with urothelial carcinoma (UC) remains controversial
A high PLR was correlated to poorer progression-free survival (PFS) (HR = 1.81, 95% confidence interval (CI) 1.28–2.56, p = 0.001) and disease-free survival (DFS) (HR = 1.09, 95% CI 1.31–2.16, p < 0.001) but not poor overall survival (OS) (HR = 1.23, 95% CI 0.95–1.59, p = 0.124) or cancer-specific survival (CSS) (HR = 1.000, 95% CI 0.998–1.002, p = 0.919) in UC
Our results demonstrated a significant correlation between elevated PLR and poor prognosis in UC
Summary
The prognostic value of pre-treatment platelet-to-lymphocyte ratio (PLR) in patients with urothelial carcinoma (UC) remains controversial. This meta-analysis aimed to identify the prognostic impact of PLR on UC. Upper tract urothelial carcinomas (UTUC) are tumors derived from the urothelium along the urinary tract [2]. Regardless of the tumor location in the upper urinary tract, radical nephroureterectomy (RNU) with bladder cuff resection is considered the standard treatment for most UTUC. Recent studies have shown that inflammation and immune responses play a role in cancer development [7,8,9].
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