Abstract
The relationship of platelet-to-lymphocyte ratio (PLR) and survival in urological cancers remained inconsistent in previous studies. Therefore, we performed a meta-analysis to assess the prognostic significance of PLR in patients with urological cancers. A literature search was performed in the PubMed, Embase, and Web of Science up to July, 2017 and study quality was obtained using the Newcastle-Ottawa Scale. To estimate the association of PLR and overall survival (OS) and other survival outcomes in urological cancers, we used pooled hazard ratios (HRs). Subgroup analyses were conducted on different ethnics, sample sizes and cut-off values. 20 high quality studies involving 7562 patients with urological cancers were included in this meta-analysis. High pretreatment PLR was significantly associated with poor OS in patients with urological cancers (pooled HR = 1.58). Elevated PLR was also correlated with other survival outcomes. However, we found that PLR was significantly relevant to the OS of patients with different types of urological cancers except bladder cancer (BCa, HR = 1.16, 95%CI: 0.96–1.41). In conclusion, elevated PLR was negatively related to the OS of patients with urological cancers, except in BCa. However, more large scale prospective studies with high quality are required in the future.
Highlights
Urological cancer contains major malignancies with high morbidity and mortality worldwide[1]
During the past few years, several studies explored the prognostic significance of platelet-to-lymphocyte ratio (PLR) in patients with urological cancers
By screening the titles and abstracts, 45 potential studies were retrieved. 25 studies were excluded after further fully reviewed because they were insufficient of data (22 studies) or didn’t use cox model and hazard ratio (HR, 3 studies14–16)
Summary
Urological cancer contains major malignancies with high morbidity and mortality worldwide[1]. Despite great progress of treatment, the prognosis and clinical outcome of urological cancers remains unsatisfactory because of local recurrence or distal metastasis. Systemic inflammation is likely to affect the tumor micro-environment and promote tumor growth, which means poor outcome[7]. Numerous studies have revealed that blood-based biomarkers show great potential in urological cancer prognosis, such as neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR)[8,9,10]. During the past few years, several studies explored the prognostic significance of PLR in patients with urological cancers. No published meta-analysis have investigated PLR and urological cancer prognosis. Different survival outcomes (overall survival, OS; cancer specific survival, CSS; progression free survival, PFS and disease free survival, DFS) in patients with urological cancers
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