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Meta-analysis of associations between neutrophil-to-lymphocyte ratio and prognosis of gastric cancer.

Chen J, Hong D, Zhai Y, Shen P - World J Surg Oncol (2015)

Bottom Line: Our analysis indicated that elevated pre-treatment NLR predicted poorer OS (HR: 2.16, 95% CI: 1.86 to 2.51, P < 0.001) and PFS (HR 2.78, 95% CI: 1.95 to 3.96; P < 0.00001) in patients with GC.Over a 3-year follow-up period, high NLR was a significant predictor of poor outcomes at year 1 (HR 1.99; 95% CI: 1.39 to 2.85; P = 0.0002), year 2 (HR 2.24; 95% CI: 1.69 to 2.97; P < 0.00001) and year 3 (HR 2.80; 95% CI: 1.98 to 3.96; P < 0.00001).Elevated preoperative NLR is associated with poorer rates of survival in GC patients and may play a role in GC surveillance programmes as a means of delivering more personalised cancer care.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, The First Affiliated Hospital of College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, People's Republic of China. angelcq6958@sina.com.

ABSTRACT

Background: The prognostic role of inflammation indices, such as the neutrophil-to-lymphocyte ratio (NLR) in gastric cancer (GC) remains controversial. We conducted a meta-analysis to determine the predictable value of NLR in the clinical outcome of GC patients.

Methods: We searched Embase, PubMed and the Cochrane Library database for relevant randomised controlled trials. Statistical analyses were conducted to calculate the hazard ratio (HR) and 95% confidence intervals of overall survival (OS) and progression-free survival (PFS) using either random-effect or fixed-effect models according to the heterogeneity of the included studies. An analysis was carried out based on data from nine studies to evaluate the association between NLR and OS in patients with GC.

Results: Our analysis indicated that elevated pre-treatment NLR predicted poorer OS (HR: 2.16, 95% CI: 1.86 to 2.51, P < 0.001) and PFS (HR 2.78, 95% CI: 1.95 to 3.96; P < 0.00001) in patients with GC. Over a 3-year follow-up period, high NLR was a significant predictor of poor outcomes at year 1 (HR 1.99; 95% CI: 1.39 to 2.85; P = 0.0002), year 2 (HR 2.24; 95% CI: 1.69 to 2.97; P < 0.00001) and year 3 (HR 2.80; 95% CI: 1.98 to 3.96; P < 0.00001).

Conclusions: Elevated preoperative NLR is associated with poorer rates of survival in GC patients and may play a role in GC surveillance programmes as a means of delivering more personalised cancer care.

No MeSH data available.


Related in: MedlinePlus

Forest plots of survival in pretreatment HNLRversusLNLR patients for studies. (a) NLR and OS in GC. (b) NLR and tumour stage in GC. (c) OS In GC patients undergoing resection. (d) OS In GC patients undergoing palliative chemotherapy. (e) PFS In GC patients undergoing palliative chemotherapy.
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Fig2: Forest plots of survival in pretreatment HNLRversusLNLR patients for studies. (a) NLR and OS in GC. (b) NLR and tumour stage in GC. (c) OS In GC patients undergoing resection. (d) OS In GC patients undergoing palliative chemotherapy. (e) PFS In GC patients undergoing palliative chemotherapy.

Mentions: There were nine cohorts presenting data for pre-treatment NLR and OS in GC patients. However, with heterogeneity (I2 65%, P = 0.004), the pooled HR of 2.16 (95% CI: 1.86 to 2.51, P < 0.001) showed that patients with elevated NLR were expected to have shorter OS after treatment. The forest plot for this is shown in Figure 2a.Figure 2


Meta-analysis of associations between neutrophil-to-lymphocyte ratio and prognosis of gastric cancer.

Chen J, Hong D, Zhai Y, Shen P - World J Surg Oncol (2015)

Forest plots of survival in pretreatment HNLRversusLNLR patients for studies. (a) NLR and OS in GC. (b) NLR and tumour stage in GC. (c) OS In GC patients undergoing resection. (d) OS In GC patients undergoing palliative chemotherapy. (e) PFS In GC patients undergoing palliative chemotherapy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4379945&req=5

Fig2: Forest plots of survival in pretreatment HNLRversusLNLR patients for studies. (a) NLR and OS in GC. (b) NLR and tumour stage in GC. (c) OS In GC patients undergoing resection. (d) OS In GC patients undergoing palliative chemotherapy. (e) PFS In GC patients undergoing palliative chemotherapy.
Mentions: There were nine cohorts presenting data for pre-treatment NLR and OS in GC patients. However, with heterogeneity (I2 65%, P = 0.004), the pooled HR of 2.16 (95% CI: 1.86 to 2.51, P < 0.001) showed that patients with elevated NLR were expected to have shorter OS after treatment. The forest plot for this is shown in Figure 2a.Figure 2

Bottom Line: Our analysis indicated that elevated pre-treatment NLR predicted poorer OS (HR: 2.16, 95% CI: 1.86 to 2.51, P < 0.001) and PFS (HR 2.78, 95% CI: 1.95 to 3.96; P < 0.00001) in patients with GC.Over a 3-year follow-up period, high NLR was a significant predictor of poor outcomes at year 1 (HR 1.99; 95% CI: 1.39 to 2.85; P = 0.0002), year 2 (HR 2.24; 95% CI: 1.69 to 2.97; P < 0.00001) and year 3 (HR 2.80; 95% CI: 1.98 to 3.96; P < 0.00001).Elevated preoperative NLR is associated with poorer rates of survival in GC patients and may play a role in GC surveillance programmes as a means of delivering more personalised cancer care.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, The First Affiliated Hospital of College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, People's Republic of China. angelcq6958@sina.com.

ABSTRACT

Background: The prognostic role of inflammation indices, such as the neutrophil-to-lymphocyte ratio (NLR) in gastric cancer (GC) remains controversial. We conducted a meta-analysis to determine the predictable value of NLR in the clinical outcome of GC patients.

Methods: We searched Embase, PubMed and the Cochrane Library database for relevant randomised controlled trials. Statistical analyses were conducted to calculate the hazard ratio (HR) and 95% confidence intervals of overall survival (OS) and progression-free survival (PFS) using either random-effect or fixed-effect models according to the heterogeneity of the included studies. An analysis was carried out based on data from nine studies to evaluate the association between NLR and OS in patients with GC.

Results: Our analysis indicated that elevated pre-treatment NLR predicted poorer OS (HR: 2.16, 95% CI: 1.86 to 2.51, P < 0.001) and PFS (HR 2.78, 95% CI: 1.95 to 3.96; P < 0.00001) in patients with GC. Over a 3-year follow-up period, high NLR was a significant predictor of poor outcomes at year 1 (HR 1.99; 95% CI: 1.39 to 2.85; P = 0.0002), year 2 (HR 2.24; 95% CI: 1.69 to 2.97; P < 0.00001) and year 3 (HR 2.80; 95% CI: 1.98 to 3.96; P < 0.00001).

Conclusions: Elevated preoperative NLR is associated with poorer rates of survival in GC patients and may play a role in GC surveillance programmes as a means of delivering more personalised cancer care.

No MeSH data available.


Related in: MedlinePlus