Prognostic value of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in laryngeal cancer: What should we expect from a meta-analysis?

Abstract

BackgroundAlthough many studies have shown the predictive value of the high neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for various cancers, there are conflicting reports regarding their role in laryngeal cancer. This study aimed to evaluate the relationship between high NLR/PLR and laryngeal cancer prognosis with the help of meta-analysis.MethodsPubMed, Embase and other databases were used to search relevant studies. The pooled hazard ratio (HR) and 95% confidence interval (CI) were calculated using either the random-effect-model or fixed-effect model. Sensitivity analyses and subgroups were used to explore potential sources of heterogeneity. Publication bias was also adopted.Result5716 patients from 20 studies were involved in this meta-analysis. Pooled observed survival (OS) (HR=1.70, 95%CI, 1.41-2.04, p<0.001), progression-free survival (PFS) (HR=1.81, 95%CI, 1.47-2.23, p<0.001), and disease-free survival (DFS) (HR=1.86, 95%CI, 1.45-2.38, p<0.001) showed the prediction of high NLR for poor prognosis. It also suggested that high PLR predicted poor OS (HR=1.89, 95%CI, 1.21-2.94, p<0.001).ConclusionThis study indicated that high NLR was associated with poor OS, PFS, and DFS in laryngeal cancer patients, and high PLR was related to poor OS. Both could be potential predictors of prognosis.

Neutrophil‐to‐lymphocyte and hypopharyngeal cancer prognosis: System review and meta‐analysis

“…To the best of our knowledge, this is the first meta‐analysis to explore the prognostic value between pretreatment NLR and hypopharyngeal cancer. In a previous study 23 that included 5716 patients from 20 studies, high NLR was shown to be associated with poor OS, PFS, and DFS in laryngeal cancer. Takenaka et al, 24 Tham et al, 25 and Takenaka et al's 26 high‐quality studies also demonstrated the relationship between NLR and head and neck cancer, confirming that high pretreatment NLR is associated with poor prognosis.…”

Prognostic value of preoperative inflammatory ratios in early glottic cancer treated with transoral laser surgery

“…In recent years many retrospective studies have been conducted to determine the value of systemic inflammatory parameters as potential prognostic biomarkers in HNSCC, [13][14][15] including LSCC. 7,[16][17][18][19][20] However, most of these studies were designed and performed on heterogeneous series of patients, comprising different tumor locations and treatment regimens. For this reason, this work was focused on a specific location (the glottis) and stages (early stages I and II), as well as a single treatment (TLS) to assess the prognostic relevance of preoperative hematological parameters specifically in this subgroup of patients.…”

“…Currently there are no validated biomarkers to guide the clinical management and decision making for LSCC patients. In recent years many retrospective studies have been conducted to determine the value of systemic inflammatory parameters as potential prognostic biomarkers in HNSCC, 13–15 including LSCC 7,16–20 . However, most of these studies were designed and performed on heterogeneous series of patients, comprising different tumor locations and treatment regimens.…”

“…Specifically, in HNSCC, high pretreatment values of NLR, PLR and SIII were found to be associated with poor prognosis 13–15 . Studies focused on LSCC led to analogous results 7,16–20 . Nevertheless, most studies to date include heterogeneous series of patients who received different treatments and mixed tumors from various locations and stages.…”

“…[13][14][15] Studies focused on LSCC led to analogous results. 7,[16][17][18][19][20] Nevertheless, most studies to date include heterogeneous series of patients who received different treatments and mixed tumors from various locations and stages. Therefore, further validation of these ratios is needed using independent patient cohorts who were homogenously treated and had welldefined tumor locations and stages.…”