Prognostic Significance of Neutrophil to Lymphocyte Ratio in Oncologic Outcomes of Cholangiocarcinoma: A Meta-analysis

Tan, Deli; Fu, Yan; Qi, Shijie; Guan, Ming-Jun; Kong, P M; Wang, Shengqiang; Wang, Heling

doi:10.1038/srep33789

Cited by 52 publications

(46 citation statements)

References 34 publications

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“…A recent meta-analysis demonstrated that a high NLR was significantly associated with poor OS in patients with cholangiocarcinoma [14]. In addition, several studies demonstrated a significant correlation between GPS/modified GPS and the survival of patients with extrahepatic bile duct cancer following surgical resection [12, 13].…”

Section: Discussionmentioning

confidence: 99%

“…Neutrophil counts, lymphocyte counts, platelet counts, elevated C-reactive protein (CRP) levels, and hypoalbuminemia have been converted to ratios or scores, such as the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), and Glasgow Prognostic Score (GPS) [6], which have frequently been associated with the prognosis of solid tumors [5-7]. However, there are conflicting survival data regarding preoperative hematological inflammatory parameters in cholangiocarcinoma [8-14]. …”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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“…The neutrophil‐to‐lymphocyte ratio (NLR) is defined as the absolute neutrophil count divided by the absolute lymphocyte count, and it is a readily measurable marker of systemic inflammation. Its association with survival outcomes for various types of cancer, including head and neck squamous cell carcinoma, has been demonstrated previously . Nevertheless, the association of the NLR and anemia with either the response to induction chemotherapy or with treatment outcomes in laryngeal‐preservation protocols has not been reported to date, and we hypothesized that both associations were significant.…”

Section: Introductionmentioning

confidence: 78%

“…Its association with survival outcomes for various types of cancer, including head and neck squamous cell carcinoma, has been demonstrated previously. 5,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Nevertheless, the association of the NLR and anemia with either the response to induction chemotherapy or with treatment outcomes in laryngeal-preservation protocols has not been reported to date, and we hypothesized that both associations were significant. The aim of the present study was to determine the prognostic value of the NLR and anemia in patients treated with a laryngeal preservation protocol for laryngeal cancer.…”

Section: Introductionmentioning

confidence: 99%

Anemia and neutrophil‐to‐lymphocyte ratio in laryngeal cancer treated with induction chemotherapy

et al. 2019

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Objectives/Hypothesis We studied the influence of the neutrophil‐to‐lymphocyte ratio (NLR) and anemia on the response to induction chemotherapy (IC) and survival outcomes in laryngeal cancer patients treated with a preservation protocol. Study Design Retrospective single‐center case series. Methods We analyzed patients with T3 laryngeal cancer treated with IC using a preservation protocol. The NLR and hemoglobin levels were assessed before treatment and after IC. The response to chemotherapy was assessed using Response Evaluation Criteria in Solid Tumours 1.1 and World Heath Organization standards. The oncological endpoints were overall survival (OS) and disease‐free survival (DFS). Results Sixty‐eight patients were analyzed. The median NLR and hemoglobin levels before and after IC were 2.76 and 14.5 g/dL, and 2.01 and 11.6 g/dL, respectively. The NLR and anemia before treatment were not correlated, and they were not associated with the response to chemotherapy. However, an NLR > 5 and anemia before treatment were both associated with shorter OS and DFS. Notably, they were the only factors found to be significantly associated with survival outcomes. Conclusions In laryngeal cancer, patients treated with a preservation protocol, a high NLR ratio, and anemia before IC were associated with shorter survival, independently of the response to chemotherapy. Level of Evidence 4 Laryngoscope, 130:E144–E150, 2020

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“…A chi‐square test, Fisher's exact test, and Student's t test were used for comparisons between groups as appropriate. Neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) was calculated as follows: NLR = absolute neutrophil count/absolute lymphocyte count ; PLR = absolute platelet count/absolute lymphocyte count . Cox proportional hazard regression model was used to determine prognostic factors.…”

Section: Subjects Materials and Methodsmentioning

confidence: 99%

Clinical Characteristics and Prognostic Factors of Patients with Intrahepatic Cholangiocarcinoma with Fever: A Propensity Score Matching Analysis

et al. 2019

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Background Patients with intrahepatic cholangiocarcinoma (ICC) rarely present fever as the initial symptom. We aimed to identify clinical characteristics and prognostic factors for these feverish patients. Subjects, Materials, and Methods This study retrospectively reviewed 31 patients with ICC with fever (≥38.0°C) treated at our hospital between January 2002 and December 2014. A propensity score was used to match patients with and without fever at a ratio of 1:2. Results Patients with ICC with fever had higher serum γ‐glutamyl transferase and carcinoembryonic antigen levels, larger tumors, poorer tumor differentiation, and worse prognosis (all p < .05) than those without fever. This was supported by propensity score matching (PSM) analysis. Univariate and multivariate analyses indicated that microvascular invasion, hilar lymph node metastasis, and temperature ≥ 38.6°C were related to prognosis. Patients with ICC with fever had higher levels of leucocytes, neutrophils, neutrophil‐to‐lymphocyte ratio (NLR), and platelet‐to‐lymphocyte ratio (PLR) in peripheral blood before and after PSM analysis. Body temperature positively correlated with leucocytes (r = 0.599, p < .001), neutrophils (r = 0.644, p < .001), NLR (r = 0.681, p < .001), and PLR (r = 0.457, p = .010). Conclusion Patients with ICC with fever ≥38.0°C and ≥38.6°C had poor and extremely poor prognosis, respectively. Radical surgical treatment may improve the prognosis of patients with ICC with fever <38.6°C. However, systemic therapy (e.g., anti‐inflammatory and immune therapy) may be preferable to surgery for these patients with fever ≥38.6°C. Implications for Practice Patients with intrahepatic cholangiocarcinoma (ICC) with fever (≥38.0°C) as the initial symptom are extremely rare. Because their symptoms are similar to those of liver abscess, diagnosis is challenging, and most of these patients are already at an advanced stage at the time of diagnosis. Patients with ICC with fever had different clinical characteristics and worse prognosis than those without fever. The prognosis of those with temperature <38.6°C would be improved by timely surgical intervention. Those with fever ≥38.6°C had an extremely dismal outcome, although they all received radical surgical treatment. New therapeutic strategies are needed to improve survival for patients with ICC with temperature ≥38.6°C.

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Prognostic Significance of Neutrophil to Lymphocyte Ratio in Oncologic Outcomes of Cholangiocarcinoma: A Meta-analysis

Cited by 52 publications

References 34 publications

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

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

Anemia and neutrophil‐to‐lymphocyte ratio in laryngeal cancer treated with induction chemotherapy

Clinical Characteristics and Prognostic Factors of Patients with Intrahepatic Cholangiocarcinoma with Fever: A Propensity Score Matching Analysis

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