The clinical use of the platelet to lymphocyte ratio and lymphocyte to monocyte ratio as prognostic factors in renal cell carcinoma: a systematic review and meta-analysis.

Xuemin Wang,Yuanshan Guo,Shiqiang Su

doi:10.18632/oncotarget.21108

Xuemin Wang, Yuanshan Guo + Show 1 more

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https://doi.org/10.18632/oncotarget.21108

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Journal: Oncotarget	Publication Date: Sep 20, 2017
Citations: 23	License type: cc-by

Affiliation: First Hospital of Shijiazhuang

Abstract

Conflicting evidence exists regarding the effect of platelet to lymphocyte ratio (PLR) and lymphocyte to monocyte ratio (LMR) on the prognosis of renal cell carcinoma (RCC) patients. Here we quantify the prognostic impact of these biomarkers and assess their consistency in RCC. Eligible studies were retrieved from the PubMed, Embase and Web of Science databases. Pooled hazard ratios (HRs), odds ratios (ORs), and 95% confidence intervals (CIs) were calculated. Sixteen studies containing 6,223 patients met criteria for inclusion. Overall, elevated PLR was associated with poorer overall survival (OS, HR 1.76, 95% CI 1.41–2.19, P < 0.001), progression-free survival (PFS, HR 2.81, 95% CI 1.40-5.63, P = 0.004) and recurrence-free survival (RFS, HR 2.64, 95% CI 1.35–5.14, P = 0.004). Conversely, high LMR was correlated with more favorable OS (HR 0.62, 95% CI 0.51–0.77, P < 0.001) and RFS (HR 0.53, 95% CI 0.42–0.67, P < 0.001). Moreover, low LMR was significantly associated with some clinicopathological characteristics that are indicative of poor prognosis and disease aggressiveness. By these results, elevated PLR was associated with poor outcomes, while high LMR correlated with more favorable survival in RCC patients. Pretreatment PLR and LMR can serve as prognostic factors in RCC patients.

Highlights

Renal cell carcinoma (RCC), the seventh most common cancer for male and the ninth for female worldwide, represents 2–3% of all malignances in adults [1]
Overall, elevated platelet to lymphocyte ratio (PLR) was associated with poorer overall survival (OS, hazard ratios (HRs) 1.76, 95% confidence intervals (CIs) 1.41–2.19, P < 0.001), progression-free survival (PFS, HR 2.81, 95% CI 1.40-5.63, P = 0.004) and recurrence-free survival (RFS, HR 2.64, 95% CI 1.35–5.14, P = 0.004)
In the literatures of correlations between PLR and lymphocyte to monocyte ratio (LMR) with overall survival in renal cell carcinoma (RCC), the funnel plots seem to Presently, the identification of prognostic biomarkers mainly focuses on tumor self- presentation and biological behavior, which might not stand for the authentic burden of RCC

Summary

Introduction

Renal cell carcinoma (RCC), the seventh most common cancer for male and the ninth for female worldwide, represents 2–3% of all malignances in adults [1]. There will be 66,800 new confirmed cases and 23,400 occurred deaths in China in 2015 [2]. Despite great progress in surgical procedures, immune-therapy and targeted treatment in managing renal mass, its long-term survival remains unsatisfactory largely because of common recurrence in situ, distant metastasis and poor response rate [3]. The identification of prognosis predictors may have clinical significance to instruct therapeutic decisions and follow-up arrangements. Postoperative histopathological variables are presently the most widespread accepted factors for patients stratification [4], these parameters may not be thoroughly dependable. Since most prognosis predictors are assessed postoperatively, preoperative biomarkers are needed to early predict oncologic outcomes

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