title: Elevated Platelet to Lymphocyte Ratio Is Associated with Poor Survival Outcomes in Patients with Colorectal Cancer.
abstract: Platelet to lymphocyte ratio (PLR) is a parameter reflecting inflammatory responses in patients with cancer. Several studies have investigated the prognostic value of PLR in patients with colorectal cancer (CRC); however, the results are controversial. Thus, we carried out a meta-analysis to evaluate the association between PLR and CRC prognostication. Relevant articles were retrieved through PubMed, Embase, and Web of Science, and pooled hazard ratio (HR) and 95% confidence interval (CI) were computed by using STATA V.12.0. Both the random-effects model and fixed-effects model were utilized. A total of 13 studies (14 cohorts) with 8,601 patients were included in the meta-analysis. Pooled HRs and 95% CIs demonstrated that increased PLR predicted poor overall survival (OS) (HR = 1.81, 95%CI:1.42-2.31, p<0.001; I2 = 65%, Ph = 0.002), disease-free survival (DFS) (HR = 1.84, 95%CI:1.22-2.76, p = 0.003; I2 = 78.3%, Ph<0.001) and recurrence-free survival (RFS) (HR = 1.84, 95%CI:1.41-2.41, p<0.001; I2 = 0, Ph = 0.686), although this was not the case for cancer-specific survival (CSS) (HR = 1.75, 95%CI:0.59-5.17, p = 0.309; I2 = 66.2%, Ph = 0.085) or time to recurrence (TTR) (HR = 1.21 95%CI:0.62-2.36, p = 0.573;I2 = 58.4%, Ph = 0.121). Subgroup analysis showed that PLR enhanced the prognostic value for OS in Caucasian patients, in small sample studies and for metastatic disease; however, this was not the case with rectal cancer. Furthermore, elevated PLR predicted reduced DFS in Caucasians and not in Asians. In conclusion, our meta-analysis showed that high PLR was a significant biomarker for poor OS, DFS, and RFS in patients with CRC; however, it had no association with CSS or TTR.
authors.affiliation: Department of Radiation Oncology, Peking University First Hospital, Peking University, Beijing, China.
authors.forename: Xiaobin
authors.initials: X
authors.lastname: Gu
authors.affiliation: Department of Radiation Oncology, Peking University First Hospital, Peking University, Beijing, China.
authors.forename: Xian-Shu
authors.initials: XS
authors.lastname: Gao
authors.affiliation: Department of Radiation Oncology, Peking University First Hospital, Peking University, Beijing, China.
authors.forename: Shangbin
authors.initials: S
authors.lastname: Qin
authors.affiliation: Department of Radiation Oncology, Peking University First Hospital, Peking University, Beijing, China.
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Radiation Oncology, Peking University First Hospital, Peking University, Beijing, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Qi
authors.affiliation: Department of Radiation Oncology, Peking University First Hospital, Peking University, Beijing, China.
authors.forename: Mingwei
authors.initials: M
authors.lastname: Ma
authors.affiliation: Department of Radiation Oncology, Peking University First Hospital, Peking University, Beijing, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Yu
authors.affiliation: Department of Radiation Oncology, Peking University First Hospital, Peking University, Beijing, China.
authors.forename: Shaoqian
authors.initials: S
authors.lastname: Sun
authors.affiliation: Department of Radiation Oncology, Peking University First Hospital, Peking University, Beijing, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Zhou
authors.affiliation: Department of Radiation Oncology, Peking University First Hospital, Peking University, Beijing, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Wang
authors.affiliation: Tangshan People's Hospital, Hebei, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Xiong