Pretreatment hematologic markers as prognostic factors in patients with nasopharyngeal carcinoma

Abstract

Background:Pretreatment hematologic parameters of the inflammatory response, including lymphocyte, neutrophil, and platelet counts, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio, and platelet-to-lymphocyte ratio, have emerged as prognostic factors for patients with cancer. This systematic review and meta-analysis aimed to summarize the association between the hematologic markers and prognosis of nasopharyngeal carcinoma (NPC).Methods:A systematic search of PubMed, Google Scholar, MEDLINE, EMBASE, Web of Science, and the Cochrane Library was conducted up to April 2016. Hazard ratios (HRs) with 95% confidence intervals (95% CIs) were extracted and synthesized to examine prognostic outcomes including cancer-specific survival (CSS), overall survival (OS), progression-free survival (PFS), distant metastasis-free survival, and local relapse-free survival (LRFS).Results:Fourteen studies comprising 11,651 NPC patients were ultimately included, and all eligible studies were conducted in East Asia. The OS, CSS, PFS, distant metastasis-free survival, and LRFS risks differed among patients according to hematologic marker levels. All of the parameters were associated with prognostic outcomes in patients with NPC. NLR and lymphocyte counts were most commonly reported. A high NLR was significantly associated with poor NPC prognosis (pooled HR 1.42, 95% CI 1.21–1.67 for CSS; pooled HR 1.77, 95% CI 1.41–2.23 for OS; pooled HR 1.67, 95% CI 1.36–2.06 for PFS; pooled HR 1.64, 95% CI 1.15–2.34 for LRFS). High lymphocyte count indicated favorable NPC prognosis (pooled HR 0.72, 95% CI 0.64–0.81 for OS; pooled HR 0.71, 95% CI 0.56–0.91 for PFS).Conclusions:Meta-analysis indicated that NLR and lymphocyte counts could be prognostic predictors in NPC for East Asian population. Patients with a high NLR or low lymphocyte count had poor prognosis. However, due to the limitation of included population, the conclusion was limited to East Asian patients only.

Prognostic Significance of the Neutrophil/Lymphocyte Ratio in Patients with Non-Human Papilloma Virus-Related Oropharyngeal Cancer: A Retrospective Cohort Study

“…Meanwhile, in the study by An et al [10], patients with elevated N/L at diagnosis showed significantly worse DFS and distant metastasis-free survival, compared with patients with nonelevated N/L (47.2 vs. 73.7% and 59.2 vs. 85.1%, respectively). A recent pooled analysis summarized all these East Asian published articles and results confirmed that nasopharyngeal cancer patients with a higher N/L had both higher mortality risk and recurrence risk than those with a low N/L [15]. However, as authors declared, it should be noticed that, due to the limitation of included population, conclusions should be limited to East Asian population only.…”

Platelet count and platelet‐lymphocyte ratio as prognostic markers for head and neck squamous cell carcinoma: Meta‐analysis

“…Thus, a decreased platelet count represents severe liver cirrhosis and is a predictor of liver-related death in patients with HCC. 67,69 To utilize the data available from the literature, meta-analyses on the influence of LMR in HNSCC and those of hematologic markers in other histological types of head and neck cancer should be conducted. The effects of other hematologic markers and of markers in other histological types of head and neck cancer have also been investigated.…”

Neutrophil‐to‐lymphocyte ratio as a prognostic indicator in head and neck cancer: A systematic review and meta‐analysis

“…Despite the surfeit amount of studies published, the prognostic value of the NLR in patients with head and neck cancer remains unclear, and even controversial . There are several meta‐analyses of the NLR in nasopharyngeal cancers only . To the best of our knowledge, this is the first meta‐analysis investigating the prognostic role of NLR in head and neck cancer in all sites.…”

“…8 There are several meta-analyses of the NLR in nasopharyngeal cancers only. 9,10 To the best of our knowledge, this is the first metaanalysis investigating the prognostic role of NLR in head and neck cancer in all sites. Therefore, our purpose in this study was to consolidate the published literature in order to clarify the relationship between the pretreatment NLR and the prognosis of patients with cancer in all sites of the head and neck.…”