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Review
. 2022 Jan 16;14(2):438.
doi: 10.3390/cancers14020438.

The Value of Platelet-to-Lymphocyte Ratio as a Prognostic Marker in Cholangiocarcinoma: A Systematic Review and Meta-Analysis

Dong Liu  1 , Zoltan Czigany  1 , Lara R Heij  1   2 , Stefan A W Bouwense  3 , Ronald van Dam  3 , Sven A Lang  1 , Tom F Ulmer  1 , Ulf P Neumann  1   3 , Jan Bednarsch  1
Affiliations
Review

The Value of Platelet-to-Lymphocyte Ratio as a Prognostic Marker in Cholangiocarcinoma: A Systematic Review and Meta-Analysis

Dong Liu et al. Cancers (Basel). .

Abstract

The platelet-to-lymphocyte ratio (PLR), an inflammatory parameter, has shown prognostic value in several malignancies. The aim of this meta-analysis was to determine the impact of pretreatment PLR on the oncological outcome in patients with cholangiocarcinoma (CCA). A systematic literature search has been carried out in the PubMed and Google Scholar databases for pertinent papers published between January 2000 and August 2021. Within a random-effects model, the pooled hazard ratio (HR) and 95% confidence interval (CI) were calculated to investigate the relationships among the PLR, overall survival (OS), and disease-free survival (DFS). Subgroup analysis, sensitivity analysis, and publication bias were also conducted to further evaluate the relationship. A total of 20 articles comprising 5429 patients were included in this meta-analysis. Overall, the pooled outcomes revealed that a high PLR before treatment is associated with impaired OS (HR = 1.14; 95% CI = 1.06-1.24; p < 0.01) and DFS (HR = 1.57; 95% CI = 1.19-2.07; p < 0.01). Subgroup analysis revealed that this association is not influenced by the treatment modality (surgical vs. non-surgical), PLR cut-off values, or sample size of the included studies. An elevated pretreatment PLR is prognostic for the OS and DFS of CCA patients. More high-quality studies are required to investigate the pathophysiological basis of the observation and the prognostic value of the PLR in clinical management as well as for patient selection.

Keywords: cholangiocarcinoma (CCA); meta-analysis; oncological prognosis; platelet-to-lymphocyte ratio (PLR); systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of study selection for this study.
Figure 2
Figure 2
Forest plot of the correlation between PLR and OS in CCA patients. A random-effects model was used to estimate the relationship between PLR and OS. OS, overall survival; PLR, platelet-to-lymphocyte ratio.
Figure 3
Figure 3
Forest plot of the correlation between PLR and DFS in CCA patients. A random-effects model was used to estimate the relationship between PLR and DFS. DFS, disease-free survival; PLR, platelet-to-lymphocyte ratio.
Figure 4
Figure 4
Sensitivity analyses of the association between thePLR and DFS in CCA patients. Sensitivity analyses of the association between the PLR and DFS of 8 studies. A random-effects model was used. DFS, disease-free survival; PLR, platelet-to-lymphocyte ratio.
Figure 5
Figure 5
Sensitivity analyses of the association between thePLR andOS in CCA patients. Sensitivity analyses of the association between the PLR and OS of 20 studies. A random-effects model was used. OS, overall survival; PLR, platelet-to-lymphocyte ratio.
See this image and copyright information in PMC

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