Meta-Analysis of Hematological Biomarkers as Reliable Indicators of Soft Tissue Sarcoma Prognosis

Li, Long‐Qing; Bai, Zhenhua; Zhang, Lianghao; Zhang, Yan; Lu, Xin; Zhang, Yi; Liu, Yongkui; Jiang, Wen; Li, Jiazhen

doi:10.3389/fonc.2020.00030

“…In addition, accumulating studies have demonstrated that peripheral blood test parameters play a remarkable role in the prognosis of various malignant tumors, such as lung cancer, gastric cancer, and soft tissue sarcoma, as well as GBM. [31][32][33] Unlike genetic biomarkers, preoperative hematological markers, which are detected via noninvasive procedures and are more cost-effective, can be easily obtained from routine blood tests. In the present study, we included 194 homogenous IDH-wt GBM patients to assess preoperative risk factors for early death.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Predictors of Early Mortality Risk in Isocitrate Dehydrogenase-Wild-Type Glioblastoma Patients Treated with Standard Therapy

Zhao¹,

Li²,

Guo³

et al. 2021

CMAR

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Early identification of early mortality for glioblastoma (GBM) patients based on laboratory findings at the time of diagnosis could improve the overall survival. The study aimed to explore preoperative factors associated with higher risk of early death (within 1 year after surgery) for isocitrate dehydrogenase (IDH)-wild-type (wt) GBM patients. Patients and Methods: We conducted a retrospective analysis of 194 IDH-wt GBM patients who underwent standard treatment. The probability of dying within 1 year after gross total resection (GTR) was defined as the end point "early mortality". Retrospective collection of predictive factors including clinical characteristics and laboratory data at diagnosis. Results: Median follow-up time after GTR was 16 months (3-41 months). Forty-two patients died within 1 year after surgery (1-year mortality rate: 21.6%). All potential predictive factors were assessed on univariate analyses, which revealed the following factors as associated with higher risk of early death: older age (P = 0.013), occurrence of nonseizures symptoms (P = 0.042), special tumor positions (P = 0.046), higher neutrophil-tolymphocyte ratio (NLR) (P = 0.015), higher red blood cell distribution width (RDW) (P = 0.019), higher lactate dehydrogenase (LDH) (P = 0.005), and higher fibrinogen (FIB) (P = 0.044). In a multivariate analysis, tumor location (P = 0.012), NLR (P = 0.032) and LDH (P = 0.002) were independent predictors of early mortality. The C-index of the nomogram was 0.795. The calibration curve showed good agreement between prediction by nomogram and actual observation. Conclusion: Tumor location, preoperative elevated NLR and serum LDH level were independent predictors for 1-year mortality after GTR. We indicate that increased preoperative NLR or LDH may guide patients to review head magnetic resonance imaging (MRI) more frequently and regularly to monitor tumor progression.

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“…Previous studies and meta-analyses have reported the prognostic role of different inflammatory markers in soft tissue sarcomas (STSs) [ 41 , 42 ]. Elevated NLR and PLR and reduced LMR were demonstrated to be correlated with poor clinical outcomes in patients with STS [ 43 , 44 ]. However, most studies have analyzed STSs together with osteoblastic tumors.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Pretreated Blood Inflammatory Markers in Patients with Bone Sarcoma: A Meta-Analysis

Jiang

¹

,

Ma

²

,

Hua

³

et al. 2021

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Backgroud. Multiple studies have reported blood inflammatory markers as reliable prognostic factors in various malignant tumors. However, their prognostic effect in patients with bone sarcomas has not been determined. We performed this meta-analysis to evaluate the prognostic value of pretreated blood inflammatory markers in patients with bone sarcoma. Method. We conducted a detailed literature search in Medline and Embase databases and collected relevant publications written in English before April 2020. Overall survival (OS) and disease-free survival (DFS) were the primary and secondary outcomes, respectively. Basic features of patients, hazard ratios (HRs), and 95% confidence intervals (CI) were retrieved to assess the correlation between pretreated blood inflammatory markers and patients with bone sarcoma. This meta-analysis used Stata 12.0. Results. A total of 10 studies containing 1845 cases were included for analysis. Nine of them evaluated the neutrophil lymphocyte ratio (NLR), 7 the platelet lymphocyte ratio (PLR), and 4 the lymphocyte monocyte ratio (LMR). Pooled results revealed that higher pretreatment NLR was associated with poorer OS ( HR = 1.76 , 95% CI: 1.29–2.41, and P < 0.001 ) and DFS ( HR = 1.77 , 95% CI: 1.09–2.88, and P = 0.021 ). In contrast, a lower LMR was related to worse OS ( HR = 0.73 , 95% CI: 0.57–0.92, and P = 0.009 ), but not DFS ( HR = 0.68 , 95% CI: 0.41–1.11, and P > 0.05 ). Combined results did not show a significant predictive effect of PLR on the clinical outcomes of patients with bone sarcoma ( OS : HR = 1.32 , 95% CI: 0.99–1.75, and P > 0.05 ; DFS: HR = 1.12 , 95% CI: 0.87–1.44, P > 0.05 ). Conclusion. NLR and LMR might be promising predictive biomarkers for patients with bone sarcoma and could be used to stratify patients and provide personalized therapeutic strategies.

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“…In addition, a series of studies have reported that many inflammation-based markers were directly related to poor prognosis or post-operative complications in patients with hip fracture, including prognostic nutritional index ratio (PNI) [ 9 ], CRP/PNI ratio [ 10 ], and neutrophil-to-lymphocyte ratio (NLR) [ 11 , 12 ]. Platelet-to-lymphocyte ratio (PLR), a novel marker of systemic inflammation, has been reported to be closely related to the prognosis of many diseases, such as inflammatory diseases [ 13 ], cardiovascular disease [ 14 ], and various malignancies [ 15 – 17 ], even in the 2019-novel coronavirus disease (COVID-19) [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture

Wang¹,

Wang²,

Yang³

et al. 2020

International Orthopaedics (SICOT)

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Purpose The platelet-to-lymphocyte ratio (PLR) has been extensively studied in various diseases. However, the relationship between PLR and hip fracture remains unknown. The aim of this study was to evaluate whether PLR would be an independent prognostic factor in elderly hip fracture patients. Methods Between January 2014 and December 2018, a retrospective cohort study was conducted in a orthopaedic centre, China. A total of 460 hip fracture patients were included. PLR was calculated as the ratio of platelet to lymphocyte counts and divided into high PLR group (≥ 189) and low PLR group (< 189) by using the receiver operating characteristic (ROC) curve. The relationship between PLR and one year all-cause mortality rate was assessed by univariate and multivariate Cox proportional hazard models. Further subgroup analysis stratified by different clinical and biological characteristics was performed to make the results more accurate. Results After a median follow-up of 32.0 months (range, 12.0-75.4), 92 patients (mortality rate: 20.0%) died within one year. PLR was significantly higher in dead patients compared with alive patients (p < 0.05), and high PLR group also had a high mortality rate (32.21% vs. 14.15%, p < 0.001). After multivariate adjustment, high PLR remained an independent predictor for one year all-cause mortality (adjusted hazard ratio (HR) 1.56, 95% confidence interval (CI) 1.02-2.41, p = 0.041). Moreover, advanced age (HR 1.05, 95% CI 1.01-1.08), male (HR 1.62, 95% CI 1.06-2.45), CCI ≥ 2 (HR 2.83, 95% CI 1.64-4.89), conservative treatment (HR 5.94, 95% CI 3.71-9.73), low haemoglobin level (HR 1.02, 95% CI 1.01-1.04), and low albumin level (HR 1.07, 95% CI 1.02-1.13) were independent risk factors for survival. Furthermore, subgroup analysis results were consistent with the main findings in most stratified groups. Conclusion This study highlights that high PLR (≥ 189) is associated with increased one year all-cause mortality in elderly hip fracture patients. As PLR is a simple indicator that can be calculated from the blood routine test, it can be easily performed in usual clinical practice.

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Meta-Analysis of Hematological Biomarkers as Reliable Indicators of Soft Tissue Sarcoma Prognosis

Cited by 29 publications

References 60 publications

Preoperative Predictors of Early Mortality Risk in Isocitrate Dehydrogenase-Wild-Type Glioblastoma Patients Treated with Standard Therapy

Preoperative Predictors of Early Mortality Risk in Isocitrate Dehydrogenase-Wild-Type Glioblastoma Patients Treated with Standard Therapy

Prognostic Value of Pretreated Blood Inflammatory Markers in Patients with Bone Sarcoma: A Meta-Analysis

High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture

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