Prognostic value of the pretreatment neutrophil-to-lymphocyte ratio in cervical cancer: a meta-analysis and systematic review
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Jiayuan Wu1,*, Manyu Chen2, Caixia Liang2, Wenmei Su2,*
1Nutritional Department, The Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
2Department of Oncology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
*These authors contributed equally to this work
Jiayuan Wu, email: [email protected]
Wenmei Su, email: [email protected]
Keywords: neutrophil-to-lymphocyte ratio, cervical cancer, prognosis, meta-analysis
Received: September 07, 2016 Accepted: December 28, 2016 Published: January 06, 2017
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.
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