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. 2020 Jan 30:10:30.
doi: 10.3389/fonc.2020.00030. eCollection 2020.

Meta-Analysis of Hematological Biomarkers as Reliable Indicators of Soft Tissue Sarcoma Prognosis

Long-Qing Li  1 , Zhen-Hua Bai  1 , Liang-Hao Zhang  2 , Yan Zhang  1 , Xin-Chang Lu  1 , Yi Zhang  1 , Yong-Kui Liu  1 , Jia Wen  1 , Jia-Zhen Li  1
Affiliations

Meta-Analysis of Hematological Biomarkers as Reliable Indicators of Soft Tissue Sarcoma Prognosis

Long-Qing Li et al. Front Oncol. .

Abstract

Background: Several recent studies have reported the reliable prognostic effect of hematological biomarkers in various tumors. Yet, the prognostic value of these hematological markers in soft tissue sarcoma (STS) remains inconclusive. Thus, the aim of this meta-analysis was to check the effect of hematological markers on the prognosis of STS. Methods: We systematically searched for relevant papers published before October 2019 in the PubMed and EMBASE databases. Overall survival (OS) and disease-specific survival (DSS) were the primary outcome, whereas disease-free survival was the secondary outcome. A thorough study of hazard ratios (HR) and 95% of confidence intervals (CIs) was done for determining the prognostic significance. Results: We performed 23 studies that comprised of 4,480 patients with STS. The results revealed that higher neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), and platelet-to-lymphocyte ratio (PLR) were associated with poor OS/DFS (HR = 2.08/1.72, for NLR; HR = 1.92/1.75, for CRP, and HR = 1.86/1.61, for PLR). In contrast, a low lymphocyte-to-monocyte ratio (LMR) was relate to worse OS/DFS (HR = 2.01/1.90, for LMR). Moreover, pooled analysis illustrated that elevated NLR and CRP represents poor DSS, with HRs of 1.46 and 2.06, respectively. In addition, combined analysis revealed that higher Glasgow prognostic score (GPS) was linked to an adverse OS/DSS (HR = 2.35/2.77). Conclusion: Our meta-analysis suggested that hematological markers (NLR, CRP, PLR, LMR, and GPS) are one of the important prognostic indicators for patients affected by high-grade STS and patients with the STS being located in the extremity.

Keywords: biomarker; hematological markers; inflammation; meta-analysis; prognosis; soft tissue sarcoma.

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Figures

Figure 1
Figure 1
Flow chart of the included studies.
Figure 2
Figure 2
Forest plots of the Prognostic effect of NLR for OS/DSS/DFS.
Figure 3
Figure 3
Forest plots of the Prognostic effect of NLR for OS in different histological subtypes.
Figure 4
Figure 4
Forest plots of the Prognostic effect of CRP for OS/DSS/DFS.
Figure 5
Figure 5
Forest plots of the Prognostic effect of PLR for OS/DFS.
Figure 6
Figure 6
Forest plots of the Prognostic effect of LMR for OS/DFS.
Figure 7
Figure 7
Forest plots of the Prognostic effect of GPS for OS/DSS.
Figure 8
Figure 8
Analyses of publication bias for the relationship between NLR/CRP/PLR and OS (A) Begger's funnel plot for NLR. (B) Begger's funnel plot for CRP. (C) Begger's funnel plot for PLR.
Figure 9
Figure 9
Analyses of publication bias for the relationship between NLR/CRP/PLR and OS (A) Egger's publication bias plot for NLR. (B) Egger's publication bias plot for CRP. (C) Egger's publication bias plot for PLR.
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References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. (2019) 69:7–34. 10.3322/caac.21551 - DOI - PubMed
    1. Cormier JN, Pollock RE. Soft tissue sarcomas. CA Cancer J Clin. (2004) 54:94–109. 10.3322/canjclin.54.2.94 - DOI - PubMed
    1. Stojadinovic A, Leung DH, Hoos A, Jaques DP, Lewis JJ, Brennan MF. Analysis of the prognostic significance of microscopic margins in 2,084 localized primary adult soft tissue sarcomas. Ann Surg. (2002) 235:424–34. 10.1097/00000658-200203000-00015 - DOI - PMC - PubMed
    1. Kattan MW, Leung DH, Brennan MF. Postoperative nomogram for 12-year sarcoma-specific death. J Clin Oncol. (2002) 20:791–6. 10.1200/JCO.20.3.791 - DOI - PubMed
    1. Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. (2008) 454:436–44. 10.1038/nature07205 - DOI - PubMed

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