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

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

Abstract

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.

Suggested Citation

  • Yukinori Takenaka & Takahiro Kitamura & Ryohei Oya & Naoki Ashida & Kotaro Shimizu & Kazuya Takemura & Yoshifumi Yamamoto & Atsuhiko Uno, 2017. "Prognostic role of neutrophil–lymphocyte ratio in nasopharyngeal carcinoma: A meta-analysis," PLOS ONE, Public Library of Science, vol. 12(7), pages 1-12, July.
    • Handle: RePEc:plo:pone00:0181478
    DOI: 10.1371/journal.pone.0181478
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    References listed on IDEAS

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    1. Tong-Chun Xue & Lan Zhang & Xiao-Yin Xie & Ning-Ling Ge & Li-Xin Li & Bo-Heng Zhang & Sheng-Long Ye & Zheng-Gang Ren, 2014. "Prognostic Significance of the Neutrophil-to-Lymphocyte Ratio in Primary Liver Cancer: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-11, May.
    2. Jian Cao & Xuan Zhu & Xiaokun Zhao & Xue-Feng Li & Ran Xu, 2016. "Neutrophil-to-Lymphocyte Ratio Predicts PSA Response and Prognosis in Prostate Cancer: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-15, July.
    3. Xi Zhang & Wei Zhang & Li-jin Feng, 2014. "Prognostic Significance of Neutrophil Lymphocyte Ratio in Patients with Gastric Cancer: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-7, November.
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