PLoS ONE (Jan 2017)

Prognostic role of neutrophil-lymphocyte ratio in nasopharyngeal carcinoma: A meta-analysis.

  • Yukinori Takenaka,
  • Takahiro Kitamura,
  • Ryohei Oya,
  • Naoki Ashida,
  • Kotaro Shimizu,
  • Kazuya Takemura,
  • Yoshifumi Yamamoto,
  • Atsuhiko Uno

DOI
https://doi.org/10.1371/journal.pone.0181478
Journal volume & issue
Vol. 12, no. 7
p. e0181478

Abstract

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BACKGROUND:Inflammatory markers are used to predict prognosis of nasopharyngeal carcinoma (NPC). Previous reports of neutrophil-to-lymphocyte ratio (NLR) and NPC mortality are inconsistent. This study aimed to quantify the prognostic impact of NLR on NPC. METHODS:The primary outcome was overall survival (OS), and the secondary outcomes were disease-specific survival (DSS), progression-free survival (PFS) and distant metastasis-free survival (DMFS). We systematically searched electronic databases, identified articles reporting an association between NLR and NPC prognosis. Hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted, and pooled HRs for each outcome were estimated using random effect models. RESULTS:Nine studies enrolling 5397 patients were included in the analyses. NLR greater than the cutoff value was associated with poor overall survival (HR 1.51, 95% CI 1.27-1.78), disease-specific survival (HR 1.44, 95% CI 1.22-1.71), progression-free survival (HR 1.53, 95% CI 1.22-1.90), and distant metastasis-free survival (HR 1.83, 95% CI 1.14-2.95). CONCLUSIONS:Elevated NLR predicts worse OS, DSS, PFS and DMFS in patients with NPC.