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. 2018 Sep 17:10:3599-3610.
doi: 10.2147/CMAR.S159105. eCollection 2018.

Neutrophil-lymphocyte ratio is a predictor of prognosis in patients with castration-resistant prostate cancer: a meta-analysis

Zhun Wang  1 , Shuanghe Peng  1 , Hui Xie  1 , Linpei Guo  1 , Ning Jiang  1 , Zhiqun Shang  1 , Yuanjie Niu  1
Affiliations

Neutrophil-lymphocyte ratio is a predictor of prognosis in patients with castration-resistant prostate cancer: a meta-analysis

Zhun Wang et al. Cancer Manag Res. .

Abstract

Background: The prognostic value of neutrophil-lymphocyte ratio (NLR) in patients with castration-resistant prostate cancer (CRPC) had been investigated in previous studies; however, the results remain inconsistent. This study was aimed to investigate the prognostic value of NLR in CRPC patients.

Materials and methods: Literature was identified from PubMed, Embase, Web of Science, and Cochrane, which investigated the relationship between pretreatment NLR and prognosis in CRPC patients. HRs for overall survival (OS) and progression-free survival (PFS) were extracted from eligible studies. Heterogeneity was assessed using the I2 value. The fixed-effects model was used if there was no evidence of heterogeneity; otherwise, the random-effects model was used. Publication bias was evaluated using Begg's funnel plot test.

Results: A total of 5,705 patients from 16 studies were included in this analysis. The pooled results showed that an elevated NLR predict poor OS (pooled HR = 1.52, 95% CI: 1.41-1.63, P<0.001) and PFS (pooled HR = 1.50, 95% CI: 1.21-1.85, P<0.001) in patients with CRPC. Subgroup analysis revealed that an elevated NLR significantly predicted poor OS in Asian studies group (HR = 2.43, 95% CI: 1.47-4.01, P=0.001). The elevated NLR also significantly predicted poor PFS in Asian studies group (HR = 1.99, 95% CI: 1.30-3.06, P=0.002).

Conclusion: This study suggests that an elevated NLR predict poor prognosis in patients with CRPC.

Keywords: castration-resistant prostate cancer; meta-analysis; neutrophil-lymphocyte ratio; prognosis.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow diagram of the study selection process. Abbreviation: CRPC, castration-resistant prostate cancer.
Figure 2
Figure 2
Forest plot HR for the correlation between neutrophil–lymphocyte ratio and overall survival (A) and progression-free survival (B) in castration-resistant prostate cancer patients.
Figure 3
Figure 3
Subgroup analysis of pooled overall survival based on a neutrophil–lymphocyte ratio cutoff value (A), nation (B), treatment (C), and number of patients (D).
Figure 4
Figure 4
Subgroup analysis of pooled progression-free survival based on neutrophil–lymphocyte ratio cutoff value (A), nation (B), treatment (C), and number of patients (D).
Figure 5
Figure 5
Funnel plots based on overall survival (A) and progression-free survival (B) (Begg’s test). Abbreviation: SE, standard error.
Figure 6
Figure 6
Sensitivity analysis for overall survival (A) and progression-free survival (B) in this meta-analysis.
See this image and copyright information in PMC

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