title: Prognostic value of the pretreatment neutrophil-to-lymphocyte ratio in cervical cancer: a meta-analysis and systematic review.
abstract: The prognostic value of pretreatment neutrophil-to-lymphocyte ratio (NLR) in cervical cancer remains controversial. We conducted a meta-analysis based on the data from 13 studies with 3729 patients to evaluate the association between the pretreatment NLR and the clinical outcomes of overall survival and progression-free survival in patients with cervical cancer. The relationship between NLR and clinicopathological parameters was also assessed. Hazard ratio (HR) or odds ratio (OR) with its 95% confidence interval (CI) was used as the effect size estimate. Our analysis indicated that elevated pretreatment NLR was a poor prognostic marker for patients with cervical cancer because it predicted unfavorable overall survival (HR = 1.375, 95% CI: 1.200-1.576) and progression-free survival (HR = 1.646, 95% CI: 1.313-2.065). Increased NLR is also significantly associated with the larger tumor size (OR = 1.780, 95% CI: 1.090-2.908), advanced clinical stage (OR = 2.443, 95% CI: 1.730-3.451), and positive lymph node metastasis (OR = 2.380, 95% CI: 1.775-3.190). By these results, high pretreatment NLR predicted a shorter survival period for patients with cervical cancer, and it could be served as a novel index of prognostic evaluation in patients with cervical cancer.
authors.affiliation: Nutritional Department, The Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China.
authors.forename: Jiayuan
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Oncology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China.
authors.forename: Manyu
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Oncology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China.
authors.forename: Caixia
authors.initials: C
authors.lastname: Liang
authors.affiliation: Department of Oncology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China.
authors.forename: Wenmei
authors.initials: W
authors.lastname: Su
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood* / Q000276:immunology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D009504:Neutrophils; D016017:Odds Ratio; D011379:Prognosis; D016016:Proportional Hazards Models; D002583:Uterine Cervical Neoplasms / Q000276:immunology* / Q000401:mortality / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor
keywords: cervical cancer; meta-analysis; neutrophil-to-lymphocyte ratio; prognosis