Elevated Pretreatment Platelet-to-lymphocyte Ratio Research Articles

Pretreatment platelet-to-lymphocyte ratio (PLR) as a prognosticating indicator for gastric cancer patients receiving immunotherapy

BackgroundPrevious investigations suggest that systemic inflammation markers are able to provide prognostic value in several cancers. This study seeks to characterize the ability of pretreatment platelet-to-lymphocyte ratio (PLR) to prognosticate advanced or metastatic gastric cancer patients (AGC or MGC, respectively) receiving immunotherapy.MethodsAGC and MGC patients exposed to PD-1 inhibitors from January 2016–August 2021 in the Chinese PLA General Hospital were recruited. Correlations between PLR and overall survival (OS), progression-free survival (PFS), and immunotherapy-associated tumor response rates were determined.Results237 patients were enrolled for this retrospective investigation. The 6 month and 12 month PFS based on the area under the curve value was 0.60 and 0.65 (p < 0.05). based on a calculated PLR cut-off value of 139.41, The PLR < 139.41 group has a longer OS in contrast with the PLR ≥ 139.41 group (13.46 m vs 10.71 m, HR = 0.57, 95% CI 0.42–0.78, p = 0.004). The PLR < 139.41 group had a PFS of 7.93 m in contrast to the 4.75 m seen in those with PLR ≥ 139.41 group (HR = 0.57, 95% CI 0.43–0.76, p = 0.002). The disease control rate (DCR) and objective response rate (ORR) were 86.17% and 30.85%, respectively, in the PLR < 139.41 group, but were 82.52% and 32.17%, respectively in the PLR ≥ 139.41 group. Both groups did not show any marked differences in terms of ORR and DCR (p = 0.887, p = 0.476). PLR is an independent prognostic indicator for OS and PFS upon uni- and multivariate analyses (p < 0.05).ConclusionsPre-treatment PLR correlated significantly with PFS and OS in AGC and MGC patients who received immunotherapy. An elevated PLR may provide guidance on subsequent treatment options.

The Value of Platelet-to-Lymphocyte Ratio as a Prognostic Marker in Cholangiocarcinoma: A Systematic Review and Meta-Analysis.

Simple SummaryPlatelet-to-lymphocyte ratio has shown prognostic value in several malignancies; however, its role in cholangiocarcinoma remains to be determined. Therefore, we conducted a systematic review and meta-analysis of the currently available literature. Overall, our analysis revealed that a high platelet-to-lymphocyte ratio before treatment is associated with an impaired long-term oncological outcome. Further, our results indicate that this assumption was not influenced by the used treatment modality (surgical vs. non-surgical), PLR cut-off values, study population age, or sample size of the included studies. Thus, an elevated pretreatment platelet-to-lymphocyte ratio has valid prognostic value for cholangiocarcinoma patients.The platelet-to-lymphocyte ratio (PLR), an inflammatory parameter, has shown prognostic value in several malignancies. The aim of this meta-analysis was to determine the impact of pretreatment PLR on the oncological outcome in patients with cholangiocarcinoma (CCA). A systematic literature search has been carried out in the PubMed and Google Scholar databases for pertinent papers published between January 2000 and August 2021. Within a random-effects model, the pooled hazard ratio (HR) and 95% confidence interval (CI) were calculated to investigate the relationships among the PLR, overall survival (OS), and disease-free survival (DFS). Subgroup analysis, sensitivity analysis, and publication bias were also conducted to further evaluate the relationship. A total of 20 articles comprising 5429 patients were included in this meta-analysis. Overall, the pooled outcomes revealed that a high PLR before treatment is associated with impaired OS (HR = 1.14; 95% CI = 1.06–1.24; p < 0.01) and DFS (HR = 1.57; 95% CI = 1.19–2.07; p < 0.01). Subgroup analysis revealed that this association is not influenced by the treatment modality (surgical vs. non-surgical), PLR cut-off values, or sample size of the included studies. An elevated pretreatment PLR is prognostic for the OS and DFS of CCA patients. More high-quality studies are required to investigate the pathophysiological basis of the observation and the prognostic value of the PLR in clinical management as well as for patient selection.

Prognostic significance of platelet-to-lymphocyte ratio in urothelial carcinoma patients: a meta-analysis

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.

Platelet-to-lymphocyte ratio as a potential prognostic factor in nasopharyngeal carcinoma: A meta-analysis.

Background:The aim of this study was to investigate the use of pretreatment platelet-to-lymphocyte ratio (PLR) as a prognostic marker in patients with nasopharyngeal carcinoma (NPC).Methods:A literature search was conducted using online databases such as MEDLINE, EMBASE, Cochrane Library, and WangFang. Overall survival (OS), progression-free survival (PFS), and clinicopathological features were generated and compared.Results:Ten studies that included 3388 patients were analyzed in this meta-analysis. Among them, 8 studies with 3033 patients with NPC investigated the prognostic role of PLR for OS and showed that elevated PLR was associated with poor OS (HR: 1.77, 95% CI: 1.46–2.15, P < .001). Five studies that included 1156 patients investigated the role of PLR in predicting PFS, and showed that high PLR was associated with poor PFS (HR: 1.65, 95% CI: 1.26–2.17, P < .001). Moreover, high PLR correlated with the N stage (N2-3 vs N0-1; OR: 1.55, 95% CI: 1.02–2.34, P = .04).Conclusion:Our study suggested that high PLR is associated with worse prognosis in patients with NPC. Pretreatment PLR could serve as a simple, promising indicator for prognostic evaluation in patients with NPC.

Prognostic Significance of Platelet-to-Lymphocyte Ratio in Cholangiocarcinoma: A Meta-Analysis.

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.

Prognostic Role of Platelet-to-Lymphocyte Ratio in Hepatocellular Carcinoma with Different BCLC Stages: A Systematic Review and Meta-Analysis

The role of platelet-to-lymphocyte ratio (PLR) in the prognosis of hepatocellular carcinoma (HCC) patients with different Barcelona Clinic Liver Cancer (BCLC) stages remains controversial. This systematic review and meta-analysis aimed to determine the efficacy of PLR on HCC prognosis. Five electronic databases were searched for clinical trials focusing on the role of PLR in the prognosis of HCC. A total of 297 potential studies were initially identified, and 9 studies comprising 2449 patients were finally enrolled to evaluate the association between the pretreatment PLR and clinical outcomes of overall survival (OS), disease-free survival (DFS), and event occurrence in patients with HCC in different BCLC stages. An elevated pretreatment PLR indicated unfavorable worse OS (HR = 1.73; 95% CI: (1.46, 2.04); P < 0.00001) and DFS (HR = 1.30; 95% CI: (1.06, 1.60); P = 0.01). Subgroup analysis indicated that high PLR indicated poor OS among BCLC-B/C patients without heterogeneity, while PLR in BCLC-A patients indicated high statistical heterogeneity with I2 value of 78%. As for the correlation between PLR and event occurrence, high PLR was related to poor clinical event occurrence only among BCLC-C patients, though obvious heterogeneity was observed in all different BCLC stages. In conclusion, PLR may be a significant biomarker in the prognosis of HCC in different BCLC stages.

Prognostic significance of platelet-to-lymphocyte ratio in patients with ovarian cancer: A meta-analysis.

The platelet-to-lymphocyte ratio (PLR) has been found to predict clinical outcomes in borderline ovarian tumours and the other genital neoplasms. However, its prognostic value in patients with ovarian cancer remains controversial. The aim of this study was to assess its prognostic value in ovarian cancer. We searched MEDLINE, EMBASE and the Cochrane databases to identify studies evaluating the prognostic significance of pretreatment PLR in ovarian cancer. The end points were overall survival (OS) and progression-free survival (PFS). Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using fixed-effects/random-effects models. A total of 11 studies comprising 3574 patients with ovarian cancer were included. The random-effects meta-analysis demonstrated that patients with elevated PLR had shorter OS (HR: 1.48, 95% CI: 1.24-1.76, P<.001) and PFS (HR: 1.38, 95% CI: 1.17-1.63, P<.001). The negative prognostic impact of high PLR on OS and PFS remained substantial in Asian populations, patients with PLR≥200 and studies with NOS score≥7. Elevated pretreatment PLR could be an unfavourable prognostic factor for clinical outcomes in patients with ovarian cancer.

Platelet-to-lymphocyte ratio in peripheral blood: A novel independent prognostic factor in patients with melanoma

ObjectivesThis retrospective study aimed to investigate the prognostic value of pre-treatment platelet-to-lymphocyte ratio (PLR), which is an inflammatory indicator, in patients with melanoma. MethodsPatients in this retrospective analysis were admitted between January 1, 2010 and December 31, 2015 in Henan Cancer Hospital. Receiver operating characteristic (ROC) curve was performed the optimal cut-off value for PLR. The 140 patients were divided into two groups: high PLR group and low PLR group. The relationship between PLR and overall survival (OS) was analyzed. The Kaplan-Meier and Log rank tests were used for univariate survival analysis and Cox proportional hazards regression model for multivariate analysis. ResultsThe optimal cut-off value of PLR determined by ROC curve was 120.15. Univariate and Cox multivariate survival analysis all showed that PLR and clinical stage were factors affecting OS in melanoma patients (P < 0.05). The overall median OS was 21.0 months (95% confidence interval (CI): 18.1–23.9), for 17.0 months in the high PLR group, and 34.0 months in the low PLR group (hazard ratio: 0.436, 95% CI: 0.291–0.652, P < 0.001), respectively. Clinical subgroup analysis showed that PLR was a risk factor in patients with stage II, III, and IV disease (P < 0.05). ConclusionThe elevated PLR was an independent prognostic predictor for OS in patients with melanoma.

The prognostic role of pretreatment platelet-to-lymphocyte ratio as predictors in patients with colorectal cancer: a meta-analysis.

This meta-analysis was designed to analyze and evaluate the prognostic role of preoperative or pretreatment platelet-to-lymphocyte ratio (PLR) in patients with colorectal cancer (CRC). We searched PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and WanFang Database up to April 2016. A total of 16 studies (n = 5068 participants) were included for this meta-analysis. Elevated PLR has a close relationship with the poor overall survival of CRC, with the pooled hazard ratio being 1.88 (95% CI: 1.50, 2.36; p < 0.00001). This meta-analysis indicated that pretreatment PLR may be a cost-effective and noninvasive serum biomarker for poor prognosis for patients with CRC.

Clinicopathological and prognostic significance of platelet-to-lymphocyte ratio in patients with hepatocellular carcinoma.

The platelet-to-lymphocyte ratio (PLR) is reported to be a prognostic factor in multiple malignancies. The aim of this study was to assess its prognostic value in hepatocellular carcinoma (HCC). We performed comprehensive searches of electronic databases for relevant studies. A total of eleven studies comprising 2,507 patients were included. Elevated PLR was significantly associated with poor overall survival (OS) (HR = 1.78; 95% CI = 1.36-2.34; P < 0.001) and disease-free survival (DFS)/recurrence-free survival (RFS) (HR = 1.82; 95% CI = 1.56-2.13; P < 0.001). The findings from most subgroup analyses were consistent with those from the overall analysis. In addition, a high PLR correlated with tumor size > 3 cm, TNM stage, lymph node metastasis, distant metastasis, and vascular invasion. We therefore conclude that elevated pretreatment PLR may be predicative of a poor prognosis in patients with HCC.

Pretreatment platelet-to-lymphocyte ratio (PLR) as a predictor of response to first-line platinum-based chemotherapy and prognosis for patients with non-small cell lung cancer.

Previous studies showed the platelet-to-lymphocyte ratio (PLR) was associated with the prognosis of many tumors. However, to our knowledge, no study has explained the role of PLR in predicting response to first-line chemotherapy and prognosis for patients with non-small cell lung cancer (NSCLC). The aim of this study was to characterize the role of pretreatment PLR in NSCLC. We consecutively enrolled 210 patients who were diagnosed with NSCLC in Jinling hospital (Nanjing, China) between January 2001 and August 2012. The platelet and lymphocyte counts of peripheral blood were measured before treatment was initiated. Each patient received at least two cycles of standardized combination chemotherapy. The response to chemotherapy was assessed after two cycles. Based on a receiver operator characteristic (ROC) curve, 152.6 was defined as the cut-off value of PLR for predicting response. An evaluated PLR (≥152.6) was an independent risk factor for response to first-line chemotherapy [odds ratio (OR), 4.503; 95% confidence interval (CI): 2.213-9.166, P=0.000]. Univariate and multivariate survival analyses showed that an elevated PLR was associated with a poor prognosis for patients with NSCLC [hazard ratio (HR), 1.867; 95% CI: 1.328-2.625; HR, 2.025; 95% CI: 1.405-2.919, respectively]. Our study shows that PLR maybe a potentially useful biomarker for predicting response to first-line chemotherapy and prognosis in NSCLC.