Effects of Preoperative Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios on Survival in Patients with Extrahepatic Cholangiocarcinoma

Kitano, Yuki; Yamashita, Yo Ichi; Yamamura, Kensuke; Arima, Kei; Kaida, Takayoshi; Miyata, Tatsunori; Nakagawa, Shigeki; Mima, Kosuke; Imai, Katsunori; Hashimoto, Daisuke; Chikamoto, Akira; Baba, Hideo

doi:10.21873/anticanres.11685

Cited by 36 publications

(43 citation statements)

References 24 publications

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“…After screening the titles and abstracts carefully, 75 articles were excluded. Finally, a total of 9 studies were included in the meta-analysis [ 13 – 15 , 19 – 24 ]. All of the included studies were retrospective observational cohorts.…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2018

BioMed Research International

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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.

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Section: Resultsmentioning

confidence: 99%

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

et al. 2018

BioMed Research International

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“…However, controversies still exist regarding the prognostic value of NLR in cholangiocarcinoma [8-12, 26]. Likewise, conflicting survival data are present regarding PLR in cholangiocarcinoma patients [10, 12, 26, 27]. A possible cause of the conflicting results regarding the prognostic significance of NLR and PLR in cholangiocarcinoma is that the reported cutoffs of these indices were different.…”

Section: Discussionmentioning

confidence: 99%

Association of Preoperative Platelet-to-Lymphocyte Ratio with Poor Outcome in Patients with Distal Cholangiocarcinoma

et al. 2019

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Background: Several preoperative systemic inflammatory parameters, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and Glasgow Prognostic Score, have been reported to be associated with the prognosis of solid tumors. However, there are conflicting survival data regarding these parameters in cholangiocarcinoma. Objectives: In this study, we performed a retrospective cohort analysis of patients with distal cholangiocarcinoma (DCC) who underwent surgical resection to evaluate the prognostic value of a cluster of preoperative hematological inflammatory parameters for survival. Method: Fifty-three patients with DCC who underwent pancreaticoduodenectomy with curative intent were enrolled. The optimal cutoff values of hematological inflammatory parameters, including the absolute lymphocyte count, NLR, PLR, and LMR, were determined by time-dependent receiver operating characteristic analysis. Results: The univariate analysis for overall survival (OS) of conventional factors and hematological inflammatory parameters identified that portal vein invasion and PLR had p values of ≤0.1. The univariate analysis for disease-free survival (DFS) identified that lymph node metastasis, PLR, lymphocyte count, and number of positive lymph nodes (≥3) had p values of ≤0.1. These factors were incorporated into the full model and variables were selected using the backward stepwise method. The multivariate analysis identified portal vein invasion and high PLR as independent prognostic factors for OS (p = 0.033 and 0.039, respectively) and high PLR and number of positive lymph nodes (≥3) as independent prognostic factors for DFS (p = 0.016 and 0.004, respectively). Conclusions: Preoperative PLR assessment may be useful for detecting high-risk DCC patients undergoing surgical resection for aggressive adjuvant therapy.

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“…Biomarkers of inflammation, such as NLR or PLR, have been associated with the prognosis of patients with various cancers7, 8 and have specifically been shown to be predictive markers of postoperative prognosis in gastric cancer,14 cholangiocarcinoma,15 hepatocellular carcinoma,8 and primary lung cancer 16. Some studies have reported that host‐derived inflammation, immune response, and coagulation status play important roles in tumor growth, invasion, angiogenesis, and metastasis 17…”

Section: Discussionmentioning

confidence: 99%

Platelet‐to‐lymphocyte ratio predicts the prognosis of patients with non‐small cell lung cancer treated with surgery and postoperative adjuvant chemotherapy

et al. 2017

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BackgroundMarkers of preoperative tumor immunity, such as platelet‐to‐lymphocyte ratio (PLR), have been reported to be prognostic factors for patients with various cancers. However, the relationship between PLR and the prognosis of non‐small cell lung cancer (NSCLC) patients treated with surgery and adjuvant chemotherapy as a multidisciplinary treatment is unknown.MethodsWe enrolled 327 NSCLC patients treated surgically with or without adjuvant chemotherapy (78 and 249 patients, respectively) at our hospital from 2008 to 2012. Patients had no preoperative hematological disease or infection. Preoperative PLR and clinicopathologic characteristics were recorded and their potential associations and prognostic values were assessed by Kaplan–Meier and multivariate Cox regression. The optimal cut‐off value for high and low PLR was calculated from receiver operating characteristic curves.ResultsThe five‐year overall survival rates for patients with low and high PLR were 78% and 57% (P < 0.01) for all patients, and 69% and 37% (P < 0.01) for patients who received adjuvant chemotherapy, respectively. Similarly, the five‐year disease‐free survival rates for patients with low and high PLR were 66% and 62% (P = 0.03) for all patients, and 47% and 14% (P < 0.01) for patients who received adjuvant chemotherapy, respectively. Cox proportional hazard regression indicated that high PLR was an independent prognostic factor for both overall and disease‐free survival in the adjuvant chemotherapy group.ConclusionElevated PLR predicts poor prognosis in surgically treated NSCLC patients, especially those who receive adjuvant chemotherapy.

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Effects of Preoperative Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios on Survival in Patients with Extrahepatic Cholangiocarcinoma

Abstract: High preoperative PLR was an independent predictor of poor prognosis for patients with ECC who underwent resections.

Cited by 36 publications

References 24 publications

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

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

Association of Preoperative Platelet-to-Lymphocyte Ratio with Poor Outcome in Patients with Distal Cholangiocarcinoma

Platelet‐to‐lymphocyte ratio predicts the prognosis of patients with non‐small cell lung cancer treated with surgery and postoperative adjuvant chemotherapy

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