Platelet-Lymphocyte Ratio as a Predictor of Prognosis in Head and Neck Cancer: A Systematic Review and Meta-Analysis

Abstract

The aim of this systematic review and meta-analysis was to investigate the prognostic utility of the platelet-to-lymphocyte ratio (PLR) in head and neck cancer. Medline (via PubMed), EMBASE, Scopus, and the Cochrane Library databases were searched from their inception to May 2017 for relevant literature. A systematic review and meta-analysis were performed to generate the pooled hazard ratios (HR) for overall survival (OS) and disease-specific survival (DSS). The study was conducted in accordance with the Cochrane Handbook and PRISMA guidelines. Risk of bias was assessed using the QUIPS tool. The logarithm of the HR with standard error was used as the primary summary statistic. Heterogeneity was assessed using Cochran’s Q and Higgins’ I<sup>2</sup>. A total of 13 studies were included in the final analysis, combining data from 4,541 patients. The results demonstrated that an elevated PLR was significantly associated with poorer OS [HR 1.85, 95% CI 1.35–2.52, <i>p</i> < 0.00001] and DSS [HR 1.57, 95% CI 1.25–1.97, <i>p</i> < 0.0001]. Significant heterogeneity was detected for the pooled end points. Subgroup analysis demonstrated reduction of heterogeneity by controlling for sample size and cutoff value. 95% prediction intervals showed wide ranges crossing the null threshold.

Systemic Inflammation Response Index Is a Predictor of Poor Survival in Locally Advanced Nasopharyngeal Carcinoma: A Propensity Score Matching Study

“…Increasing evidence has shown that systemic immune response markers are promising prognostic biomarkers for various cancers. The combined indicators of neutrophils, lymphocytes, monocytes, and platelets, such as NLR ( 18 , 19 ), PLR ( 20 ), SII ( 21 , 22 ) and SIRI ( 23 , 24 ), have been reported to be predictive of cancer prognosis. SIRI is a new systemic inflammatory response biomarker based on neutrophil, monocyte, and lymphocyte counts.…”

Prognostic evaluation of colorectal cancer using three new comprehensive indexes related to infection, anemia and coagulation derived from peripheral blood

“…In recent years, a wide variety of blood indicators with different changes were concerned and discussed in the study of malignant tumor diseases including CRC: Qian W, et al reported that the post-/pre-treatment MPV (Mean Platelet Volume) ratio were prognostic factors for OS in resectable CRCs [10] ; Preoperative neutrophil-lymphocyte ratio (NLR) and red blood cell distribution width (RDW), especially the independent prediction of NLR, were confirmed as effective biomarkers for clinical diagnosis and prognosis evaluation of esophageal cancers [11] ; In patients with pathologic stage I non-small cell lung cancer undergoing surgical resection, high LY and PLT count from peripheral blood could provide poor prognostic value independently [12] ; Even the ratios between indicators were developed into new indexes, which had fairly good prognostic significance, including NLR, Platelet-to-Lymphocyte Ratio (PLR), Lymphocyte-to-Monocyte ratio (LMR). [13][14][15][16] .…”

The Acute Phase Reaction and Its Prognostic Impact in Patients with Head and Neck Squamous Cell Carcinoma: Single Biomarkers Including C-Reactive Protein Versus Biomarker Profiles

“…Inflammatory parameters are considered as possible prognostic markers in several human malignancies [ 9 , 55 ]. These parameters include both acute phase proteins and peripheral blood concentrations of various leukocyte subsets and platelets [ 62 , 72 , 73 , 74 , 75 ]. Increased leukocyte and platelet counts were also seen for several of our HNSCC patients, and we observed significant correlations between IL6 levels, WBC counts, and CRP levels.…”