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Prognostic Role of Neutrophil-to-Lymphocyte Ratio in Prostate Cancer

View Article: PubMed Central - PubMed

ABSTRACT

Inflammation is increasingly reported to be associated with the prognosis of patients with cancers. And the prognostic role of neutrophil-to-lymphocyte ratio (NLR) in patients with prostate cancer (PCa) remains inconsistent. Therefore, we conducted this systematic review and meta-analysis to obtain a more reliable assessment of prognostic significance of NLR in PCa.

A comprehensive literature research regarding the association of NLR and prognosis of PCa was performed through PubMed, Embase, Cochrane Central, and Web of Science. The hazard ratios (HRs) and its 95% confidence intervals (CIs) for overall survival (OS), progression-free survival, or recurrence-free survival were extracted and pooled using fix-effects model or random-effects model.

A total of 14 studies that met our criterion were included in this meta-analysis. Our pooled results demonstrated that elevated NLR was not significantly associated with the poor OS (HR = 1.45; 95% CI 0.77–2.71; P = 0.248) or recurrence-free survival (HR = 1.34; 95% CI 0.89–2.02; P = 0.155) of patients with localized PCa. Although elevated NLR predicted poorer OS (HR = 1.57; 95% CI 1.41–1.74; P < 0.001) and progression-free survival (HR = 1.97; 95% CI 1.28–3.04; P = 0.002) of patients with metastatic castration resistant prostate cancer (mCRPC).

Elevated NLR is a strong indicator of poorer prognosis of patients with mCRPC, whereas the NLR is not significantly associated with prognosis of patients with localized PCa. Therefore, NLR could be used in patients with mCRPC for risk stratification and decision making of individual treatment.

No MeSH data available.


Flow chat of literature search and selection.
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Figure 1: Flow chat of literature search and selection.

Mentions: A total of 97 records were identified after the primary comprehensive literature research using aforementioned strategy. Twenty-four duplicated items were excluded. After screening the titles and abstracts of identified records, 48 studies were excluded for the reasons, including animal studies, reviews, letters, case reports, and other irrelevant studies. After full text assessment, 11 studies did not evaluate the relationship between NLR and survival separately, or failed to report the key data (HR, 95% CI, or P value). Thus, 14 studies with 16,598 PCa patients,12,19–31 which met our selection criterion, were eventually included in our research. They were all of high quality for our analysis by meta-analysis of observational studies in epidemiology assessment. And the flowchart of the study selection process was shown in Figure 1.


Prognostic Role of Neutrophil-to-Lymphocyte Ratio in Prostate Cancer
Flow chat of literature search and selection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998274&req=5

Figure 1: Flow chat of literature search and selection.
Mentions: A total of 97 records were identified after the primary comprehensive literature research using aforementioned strategy. Twenty-four duplicated items were excluded. After screening the titles and abstracts of identified records, 48 studies were excluded for the reasons, including animal studies, reviews, letters, case reports, and other irrelevant studies. After full text assessment, 11 studies did not evaluate the relationship between NLR and survival separately, or failed to report the key data (HR, 95% CI, or P value). Thus, 14 studies with 16,598 PCa patients,12,19–31 which met our selection criterion, were eventually included in our research. They were all of high quality for our analysis by meta-analysis of observational studies in epidemiology assessment. And the flowchart of the study selection process was shown in Figure 1.

View Article: PubMed Central - PubMed

ABSTRACT

Inflammation is increasingly reported to be associated with the prognosis of patients with cancers. And the prognostic role of neutrophil-to-lymphocyte ratio (NLR) in patients with prostate cancer (PCa) remains inconsistent. Therefore, we conducted this systematic review and meta-analysis to obtain a more reliable assessment of prognostic significance of NLR in PCa.

A comprehensive literature research regarding the association of NLR and prognosis of PCa was performed through PubMed, Embase, Cochrane Central, and Web of Science. The hazard ratios (HRs) and its 95% confidence intervals (CIs) for overall survival (OS), progression-free survival, or recurrence-free survival were extracted and pooled using fix-effects model or random-effects model.

A total of 14 studies that met our criterion were included in this meta-analysis. Our pooled results demonstrated that elevated NLR was not significantly associated with the poor OS (HR = 1.45; 95% CI 0.77–2.71; P = 0.248) or recurrence-free survival (HR = 1.34; 95% CI 0.89–2.02; P = 0.155) of patients with localized PCa. Although elevated NLR predicted poorer OS (HR = 1.57; 95% CI 1.41–1.74; P < 0.001) and progression-free survival (HR = 1.97; 95% CI 1.28–3.04; P = 0.002) of patients with metastatic castration resistant prostate cancer (mCRPC).

Elevated NLR is a strong indicator of poorer prognosis of patients with mCRPC, whereas the NLR is not significantly associated with prognosis of patients with localized PCa. Therefore, NLR could be used in patients with mCRPC for risk stratification and decision making of individual treatment.

No MeSH data available.