Prognostic role of the neutrophil-lymphocyte ratio in renal cell carcinoma: a meta-analysis.
Bottom Line: Our analysis results indicated that elevated NLR predicted poorer OS (HR=1.82, 95% CI 1.51 to 2.19) and RFS/PFS (HR=2.18, 95% CI 1.75 to 2.71) in patients with RCC.However, it differed significantly by assessment of the cut-off value defining 'elevated NLR' in RFS/PFS (p=0.004).NLR should be monitored in patients with RCC for rational risk stratification and treatment individualisation.
Affiliation: Cancer Institute, the Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China.Show MeSH
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Mentions: Visual inspection of the Begg funnel plot revealed an asymmetry (p=0.001 in OS and p=0.003 in RFS/PFS; figure 4A), which raised the possibility of publication bias. As a result, we undertook sensitivity analysis using the trim and fill method, which conservatively imputes hypothetical negative unpublished studies to mirror the positive studies that cause funnel plot asymmetry. The imputed studies produced a symmetrical funnel plot (figure 4B). The pooled analysis incorporating the hypothetical studies continued to show a statistically significant association between elevated NLR and prognosis of patients with RCC (HR=1.54, 95% CI 1.25 to 1.88; p<0.001 in OS and HR=1.85, 95% CI 1.45 to 2.36; p<0.001 in RFS/PFS).
Affiliation: Cancer Institute, the Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China.