Systematic review and meta-analysis of the prognostic value of preoperative platelet-to-lymphocyte ratio in patients with urothelial carcinoma
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Shuiqing Wu1,2,*, Qi Wan3,*, Ran Xu1, Xuan Zhu1, Haiqing He1 and Xiaokun Zhao1
1Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
2MRC Centre for Reproductive Health, Queen’s Medical Research Institute, Edinburgh, United Kingdom
3Department of Neurology, The First Hospital of Changsha, Changsha, Hunan Province, People’s Republic of China
*These authors contributed equally to this work
Xiaokun Zhao, email: [email protected]
Keywords: platelet-to-lymphocyte ratio, urothelial carcinoma, prognostic factor, meta-analysis
Received: June 14, 2017 Accepted: September 08, 2017 Published: September 22, 2017
A large number of studies have investigated the prognostic value of the platelet-to-lymphocyte ratio (PLR) in patients diagnosed with urothelial carcinoma, but the evidence from these papers is conflicting. This systematic review and meta-analysis was carried out to assess the role of PLR in urothelial carcinoma patients. After a systematic search of the PubMed, Embase, Web of science databases, the associations between PLR and overall survival (OS), cancer-specific survival (CSS)/disease-specific survival (DSS), and relapse-free survival (RFS)/disease-free survival (DFS) were analyzed in urothelial carcinoma patients. The relationship between PLR and pathological results was also evaluated. A total of seven studies (eight cohorts) comprising 3171 patients were included. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) indicated the increased preoperative PLR predicted poor OS (HR = 1.14, 95% CI = 1.01- 1.27, p < 0.001), CSS/DSS (HR = 1.24, 95% CI = 1.08–1.40, p < 0.001), RFS/DFS (HR = 1.23, 95% CI = 1.09–1.38, p < 0.001). However, no significant correlation was found between elevated preoperative PLR and pathological results such as tumor grade, tumor necrosis and T stages. These findings suggest a high PLR is associated with reduced OS, CSS/DSS and RFS/DFS in urothelial carcinoma. Preoperative PLR may therefore be a predictive factor in this patient group.
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