Prognostic value of the pretreatment neutrophil-to-lymphocyte ratio in cervical cancer: a meta-analysis and systematic review

Abstract

The prognostic value of pretreatment neutrophil-to-lymphocyte ratio (NLR) in cervical cancer remains controversial. We conducted a meta-analysis based on the data from 13 studies with 3729 patients to evaluate the association between the pretreatment NLR and the clinical outcomes of overall survival and progression-free survival in patients with cervical cancer. The relationship between NLR and clinicopathological parameters was also assessed. Hazard ratio (HR) or odds ratio (OR) with its 95% confidence interval (CI) was used as the effect size estimate. Our analysis indicated that elevated pretreatment NLR was a poor prognostic marker for patients with cervical cancer because it predicted unfavorable overall survival (HR = 1.375, 95% CI: 1.200–1.576) and progression-free survival (HR = 1.646, 95% CI: 1.313–2.065). Increased NLR is also significantly associated with the larger tumor size (OR = 1.780, 95% CI: 1.090–2.908), advanced clinical stage (OR = 2.443, 95% CI: 1.730–3.451), and positive lymph node metastasis (OR = 2.380, 95% CI: 1.775–3.190). By these results, high pretreatment NLR predicted a shorter survival period for patients with cervical cancer, and it could be served as a novel index of prognostic evaluation in patients with cervical cancer.

Prognostic role of neutrophil‐to‐lymphocyte ratio in head and neck cancer: A meta‐analysis

“…The results of our analyses are comparable to those of previously reported meta‐analyses of other types of cancer. However, the HRs for OS in the oropharyngeal cancer subgroup was much higher than that in other head and neck subgroups in this study and in subgroups of other cancers in previous studies . One of the reasons for this discrepancy is that the HRs for the oropharyngeal cancer subgroup came from only 1 study enrolling 76 patients.…”

“…Therefore, meta‐analyses should be conducted separately for each type of cancer. Recent meta‐analyses of cancer of the cervix, breast, lung, colorectum, prostate, kidney, esophagus, and liver have been published . The pooled HRs for OS in these studies range from 1.23 to 2.102.…”

“…Recent meta-analyses of cancer of the cervix, breast, lung, colorectum, prostate, kidney, esophagus, and liver have been published. [44][45][46][47][48][49][50][51][52] The pooled HRs for OS in these studies range from 1.23 to 2.102. The results of our analyses are comparable to those of previously reported meta-analyses of other types of cancer.…”

“…However, the HRs for OS in the oropharyngeal cancer subgroup was much higher than that in other head and neck subgroups in this study and in subgroups of other cancers in previous studies. 6,[44][45][46][47][48][49][50][51][52] One of the reasons for this discrepancy is that the HRs for the oropharyngeal cancer subgroup came from only 1 study enrolling 76 patients. Another reason for the discrepancy is that oropharyngeal cancer consists of 2 distinct types of cancer: HPV-negative oropharyngeal cancer, which is caused by excessive smoking and drinking, and HPV-positive oropharyngeal cancer.…”

Clinical Predictors for Neutrophil–to–Lymphocyte Ratio Changes in Patients with Chronic Hepatitis B Receiving Peginterferon Treatment

“…Because blood neutrophil and lymphocyte counts are routinely checked during clinical practice, NLR is widely used as a reference for immunological status of the patients (17). Nowadays, a higher NLR has been correlated with poorer prognosis in several malignancies (18)(19)(20)(21)(22)(23), including resectable and advanced HCC (24)(25)(26). In this way, lower NLR seems to imply a lower risk and better outcome of HCC in chronic HBV-infected patients.…”