Abstract
BackgroundThe prognostic effect of elevated systemic inflammatory markers, including neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), remains controversial in cancer patients. This meta-analysis was conducted to evaluate the predictive values of these markers for prognoses in ovarian cancer patients.MethodsPotentially relevant publications in PubMed, ISI Web of Science, and EBSCO were searched. Pooled hazard ratios (HRs) and corresponding 95% confidence intervals (95% CIs) for overall survival (OS) and progression-free survival (PFS) were determined using a fixed or random effects model.ResultsTen studies involving 2919 patients were included in this meta-analysis. In multivariate analysis, the group with higher NLR had worse OS (HR = 1.34, 95% CI = 1.16-1.54) and shorter PFS (HR = 1.36, 95% CI = 1.17-1.57) than the control group. Furthermore, PLR values higher than the cut-off were associated with not only poorer OS (HR = 1.97, 95% CI = 1.61-2.40) but also more unfavorable PFS (HR = 1.79, 95% CI = 1.46-2.20). Univariate analysis also indicated the same results. Additionally, subgroup analysis showed that when the cut-off values for NLR and PLR were higher, their predictive effects became stronger.ConclusionThis comprehensive meta-analysis suggested that the values of inflammatory markers such as NLR and PLR were associated with ovarian cancer survival. Therefore, inflammatory markers can potentially serve as prognostic biomarkers.
Highlights
The prognostic effect of elevated systemic inflammatory markers, including neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), remains controversial in cancer patients
Miao and colleagues assessed the predictive value of NLR and PLR in ovarian cancer patients, and the results suggested that patients with lower values of NLR (NLR < 3.02) or PLR (PLR < 207) had longer progressionfree survival (PFS) and overall survival (OS), and NLR and PLR are significantly related to long-term survival in ovarian cancer [10]
The present meta-analysis was performed to assess the relationship between pretreatment NLR and PLR and ovarian cancer prognosis according to the protocol of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) [12]
Summary
The prognostic effect of elevated systemic inflammatory markers, including neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), remains controversial in cancer patients. This meta-analysis was conducted to evaluate the predictive values of these markers for prognoses in ovarian cancer patients. Due to the lack of effective screening measures for the early detection of ovarian cancer, nearly 70% of ovarian cancer patients are diagnosed at an advanced stage. Systemic inflammatory responses are closely associated with cancer initiation, progression and metastasis, and inflammatory markers, including the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), have been studied and found to be related to cancer mortality and employed as useful prognostic indicators in many solid tumors [4,5,6].
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