Comparison of Prognostic Abilities Among Preoperative Laboratory Data Indices in Patients with Resectable Gastric and Esophagogastric Junction Adenocarcinoma

Urabe, Masayuki; Yamashita, Hiroharu; Watanabe, Toshiaki; Seto, Yasuyuki

doi:10.1007/s00268-017-4146-9

Cited by 34 publications

(29 citation statements)

References 48 publications

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“…Accumulated studies have assessed the association between PLR and the diagnosis and prognosis of gastric cancer. Some studies showed that elevated PLR predicted poor OS and DFS in GC patients after surgery [22,24]. However, some other studies did not detect the signi cant prognostic value of PLR for GC patients [7,47].…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological and Prognostic Significance of Platelet-Lymphocyte Ratio (PLR) in Gastric Cancer: An Updated Meta-Analysis

Zhang

Zhao

et al. 2020

Preprint

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Background: Pretreatment PLR (platelet-lymphocyte ratio), was reported to be associated with the prognosis in gastric cancer (GC), but the results remain inconclusive. This meta-analysis aimed to investigate the prognostic potential of the pre-treatment PLR in gastric cancer.Methods: We performed a systematic literature search in PubMed, Embase and the Cochrane Library to identify eligible publications. The hazard ratio (HR) /Odds Ratio (OR) and its 95% confidence (CI) of survival outcomes and clinicopathological parameters were calculated.Results: A total of 49 studies (51 cohorts), collectting data from 28,929 GC patients, were included in the final analysis. The pooled results demonstrated that the elevated pre-treatment PLR was significantly associated with poor overall survival (OS) (HR: 1.37, 95% CI: 1.26-1.49, p < 0.001; I2= 79.90%, Ph < 0.001) and disease-free survival (DFS) (HR 1.52, 95%CI 1.22–1.90, P< 0.001, I2= 88.6%, Ph< 0.001). Furthermore, the patients with the elevated PLR had a higher risk of lymph node metastasis (OR = 1.17, 95% CI: 1.02–1.33, p=0.023), serosal invasion (T3 +T4) (OR = 1.34, 95% CI: 1.10–1.64, p=0.003) and increased advanced stage (III+IV) (OR = 1.20, 95% CI: 1.06–1.37, p=0.004).Conclusions: An elevated pre-treatment PLR was a prognostic factor for poor OS and DFS, and associated with poor clinicopathological parameters in GC patients .

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Section: Discussionmentioning

confidence: 99%

Clinicopathological and Prognostic Significance of Platelet-Lymphocyte Ratio (PLR) in Gastric Cancer: An Updated Meta-Analysis

Zhang

Zhao

et al. 2020

Preprint

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“…Accumulated studies have assessed the association between PLR and the diagnosis and prognosis of 9 gastric cancer. Some studies showed that elevated PLR predicted poor OS and DFS in GC patients after surgery [22,24]. However, some other studies did not detect the significant prognostic value of PLR for GC patients [7,47].…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological and Prognostic Significance of Platelet-Lymphocyte Ratio (PLR) in Gastric Cancer: A Meta-Analysis

Zhang

Zhao

et al. 2019

Preprint

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Studies included in the meta-analysis need to meet the following criteria: (1) the diagnosis of gastric cancer must be confirmed by pathological examination; (2) there was available data to be investigated which was provided by the original article, such as HR and 95%CI for the OS and (or) DFS, the number of patients with various clinicopathological features; (3) the blood samples was obtained before treatment, PLR was calculated as the ratio of the platelets to lymphocytes; Studies were excluded based on the following criteria: (1) letters, conference abstracts, posters or review articles; (2) insufficient data to estimate from the article; (3) not human research or not published in English. Data extraction and quality assessmentAll studies were assessed independently by two authors according to the designed eligibility criteria.Any questions or disagreements were resolved by consulting another co-author. The extracted data from each study included: first author, publication year, country, study design (retrospective or prospective), study period, treatment regimens, follow-up time, cut-off value of PLR, the number of patients with various clinicopathological features, such as tumor location, differentiation, size, depths of tumor invasion, lymph node metastasis, TNM stage, HRs with 95% CIs of OS and DFS. The quality of each study was assessed according to the Newcastle-Ottawa Scale (NOS) by two authors [14]. Studies with an NOS score ≥ 6 were considered as high-quality researches. Statistical analysisHRs and 95% CIs for OS and DFS were obtained directly from each study if available or were calculated from the necessary data according to the methods published by Tierney et al. [15].Cochran's Q test and Higgins I-squared statistic were used to evaluate the heterogeneity of pooled results. A p-value < 0.1 for the Q-test or Ι2 > 50% indicated significant heterogeneity among studies, and the random-effects model (DerSimonian-Laird method) was performed to calculate the pooled HRs [14]. Otherwise, the fixed-effects model (Mantel-Haenszel method) was applied [16]. Odds ratios (OR) and 95% CI were used to analysis the relationship between PLR and clinicopathological factors.Publication bias of the literature was evaluated by Begg's funnel plot and Egger's linear regression tests, and p > 0.05 indicated that there was no significant publication bias. Sensitivity analysis was

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“…Laboratory indicators may be used as prognostic indicators for gastrointestinal tumors (14,15), including: neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte monocyte ratio (LMR), Glasgow prognostic score (GPS), and Prognostic nutritional index (PNI). Although some studies have reported the relationship between these indicators and the prognosis of patients with AEG, a consensus has not been reached.…”

Section: Introductionmentioning

confidence: 99%

“…Although some studies have reported the relationship between these indicators and the prognosis of patients with AEG, a consensus has not been reached. Urabe et al (14) indicated that preoperative NLR and PLR is associated with OS and DFS in patients with AEG. Zhou et al (16) postulated that preoperative LMR and PLR are very useful predictors for AEG surgery; but Zhang et al (17) reported that preoperative NLR can be used as prognostic factor for Siewert type II/III AEG patients, but PLR value is limited.…”

Section: Introductionmentioning

confidence: 99%

Preoperative Neutrophil Lymphocyte Ratio Can Be Used as a Predictor of Prognosis in Patients With Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Meta Analysis

et al. 2020

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Objective: Neutrophil lymphocyte ratio (NLR), Lymphocyte mononuclear cell ratio (LMR), and Platelet lymphocyte ratio (PLR) can be used as various prognostic factors for malignant tumors, but the value of prognosis for patients with adenocarcinoma of the esophagogastric junction (AEG) has not been determined. This study used meta-analysis to assess the value of these indicators in the evaluation of AEG prognosis. Methods: Relevant literatures on the prognostic relationship between NLR, LMR, PLR, and AEG was retrieved from PubMed, Web of Science, Embase, Cochrane Library, Cochrane Central Register of Controlled Trials, Wanfang data, and Chinese National Knowledge Infrastructure. The search time from database establishment to June 30, 2019. The language is limited to English and Chinese. Data was analyzed using Stata 15.0 software. Result: Six retrospective studies were included, five of them involved NLR and six of them involved PLR. No LMR literature that adequately satisfied the conditions was retrieved. Increased NLR was significantly associated with a significant reduction in overall survival (OS), cancer-specific survival (CSS), or disease specific survival (DSS) in patients with AEG [hazard ratio (HR) = 1.545, 95% CI: 1.096-2.179, P < 0.05]. Subgroup analysis showed that NLR had significant value in the prognosis of both Chinese and Non-Chinese patients (P = 0.009 vs. P = 0.000). NLR had significant prognostic value for ≥3 and <3 groups (P = 0.022 vs. P = 0.000). NLR has a significant prognostic value for samples ≥500 and <500 (P = 0.000 vs. P = 0.022). NLR and OS/CSS/DSS single factor meta-regression showed that regional NLR cutoff values and sample size may be the source of heterogeneity in AEG patients (all P < 0.05). There was no significant association between elevated PLR and OS in patients with AEG (HR = 1.117, 95% CI: 0.960-1.300, P > 0.05). PLR had no significant prognostic value for both Chinese and Liu et al. NLR Can Be Used as a Predictor of AEG UK patients (P = 0.282 vs. P = 0.429). PLR had no significant prognostic value for ≥150 group and <150 group (P = 0.141 and P = 0.724). No significant prognostic value was found in either the 300 group and <300 group (P = 0.282 vs. P = 0.429). Conclusion: Preoperative NLR rise was an adverse prognostic indicator of AEG. High-risk patients should be treated promptly. The results showed that PLR was not recommended as a prognostic indicator of AEG.

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Comparison of Prognostic Abilities Among Preoperative Laboratory Data Indices in Patients with Resectable Gastric and Esophagogastric Junction Adenocarcinoma

Abstract: Preoperative PNI, a score related to nutritional status, is of importance for predicting long-term outcomes in patients with GC and AEG.

Cited by 34 publications

References 48 publications

Clinicopathological and Prognostic Significance of Platelet-Lymphocyte Ratio (PLR) in Gastric Cancer: An Updated Meta-Analysis

Clinicopathological and Prognostic Significance of Platelet-Lymphocyte Ratio (PLR) in Gastric Cancer: An Updated Meta-Analysis

Clinicopathological and Prognostic Significance of Platelet-Lymphocyte Ratio (PLR) in Gastric Cancer: A Meta-Analysis

Preoperative Neutrophil Lymphocyte Ratio Can Be Used as a Predictor of Prognosis in Patients With Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Meta Analysis

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