Display options
Cite
Pirozzolo G, Gisbertz SS, Castoro C, et al. Neutrophil-to-lymphocyte ratio as prognostic marker in esophageal cancer: a systematic review and meta-analysis. J Thorac Dis. 2019;11(7):3136-3145doi: 10.21037/jtd.2019.07.30.
Pirozzolo, G., Gisbertz, S. S., Castoro, C., van Berge Henegouwen, M. I., & Scarpa, M. (2019). Neutrophil-to-lymphocyte ratio as prognostic marker in esophageal cancer: a systematic review and meta-analysis. Journal of thoracic disease, 11(7), 3136-3145. https://doi.org/10.21037/jtd.2019.07.30
Pirozzolo, Giovanni, et al. "Neutrophil-to-lymphocyte ratio as prognostic marker in esophageal cancer: a systematic review and meta-analysis." Journal of thoracic disease vol. 11,7 (2019): 3136-3145. doi: https://doi.org/10.21037/jtd.2019.07.30
Pirozzolo G, Gisbertz SS, Castoro C, van Berge Henegouwen MI, Scarpa M. Neutrophil-to-lymphocyte ratio as prognostic marker in esophageal cancer: a systematic review and meta-analysis. J Thorac Dis. 2019 Jul;11(7):3136-3145. doi: 10.21037/jtd.2019.07.30. PMID: 31463142; PMCID: PMC6688029.
Copy Download .nbib Format: NLM
Share it on

J Thorac Dis. 2019 Jul;11(7):3136-3145. doi: 10.21037/jtd.2019.07.30.

Neutrophil-to-lymphocyte ratio as prognostic marker in esophageal cancer: a systematic review and meta-analysis.

Journal of thoracic disease

Giovanni Pirozzolo, Suzanne S Gisbertz, Carlo Castoro, Mark Ivo van Berge Henegouwen, Marco Scarpa

Affiliations

  1. General Surgery Department, dell'Angelo Hospital, Venice, Italy.
  2. General Surgery Department, AMC-Academic Medical Center, Amsterdam, The Netherlands.
  3. Esophago-gastric Surgery Department, Humanitas Research Hospital, Rozzano, Italy.
  4. General Surgery Department, Padua Hospital, Padua, Italy.

PMID: 31463142 PMCID: PMC6688029 DOI: 10.21037/jtd.2019.07.30

Abstract

A high preoperative neutrophil-lymphocyte ratio (NLR) has been shown in several studies as a predictor of worse survival in many solid neoplasms, including esophageal cancer, but its impact remains unclear. The goal of this systematic review was to gain all the evidence about NLR in order to analyse its potential in predicting survival in esophageal cancer. Therefore, we conducted a systematic literature search of all relevant studies reporting data on NLR as prognostic marker in esophageal cancer patients. We considered overall survival (OS) as primary outcome, disease-free survival (DFS) and progression-free survival (PFS) as secondary outcomes. We included studies with a directly or indirectly available hazard ratio (HR), furthermore we used both fixed effect model and random effect model depending on heterogeneity. We included a total of 20 studies, published between 2011 and 2017, consisting of 6,457 patients. The NLR cut-off value ranges from 1.7 to 5. The HR for OS of all included studies was 1.60. The HR for DFS and PFS was 1.75 and 1.66 respectively. The survival sub-analysis about tumor characteristics, treatment modality, blood sample timing also confirmed NLR prognostic relevance with statistically significant results. The meta-analysis showed that high preoperative NLR is associated with worse survival in esophageal cancer, as shown in several solid tumors, but its use in the clinical practice is still underestimated. High-quality studies are needed to assess the most effective cut-off in survival prognostication and NLR relevance on postoperative complications.

Keywords: Neutrophil-lymphocyte ratio (NLR); esophageal cancer; markers; meta-analysis; prognosis

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

References

  1. Lancet. 2001 Feb 17;357(9255):539-45 - PubMed
  2. J Leukoc Biol. 2006 Jun;79(6):1140-9 - PubMed
  3. Breast Cancer Res Treat. 2006 Nov;100(2):229-35 - PubMed
  4. Nat Rev Immunol. 2006 Nov;6(11):836-48 - PubMed
  5. N Engl J Med. 2008 Jan 3;358(1):36-46 - PubMed
  6. Nature. 2008 Jul 24;454(7203):436-44 - PubMed
  7. Br J Cancer. 2009 Apr 21;100(8):1236-9 - PubMed
  8. PLoS Med. 2009 Jul 21;6(7):e1000097 - PubMed
  9. J Clin Epidemiol. 2009 Oct;62(10):e1-34 - PubMed
  10. World J Surg Oncol. 2010 Jan 06;8:1 - PubMed
  11. Biomarkers. 2010 Sep;15(6):516-22 - PubMed
  12. Clin Cancer Res. 2010 Dec 1;16(23):5805-13 - PubMed
  13. Cancer Res. 2011 Apr 1;71(7):2411-6 - PubMed
  14. Br J Cancer. 2011 Apr 12;104(8):1288-95 - PubMed
  15. World J Surg. 2011 Aug;35(8):1861-6 - PubMed
  16. Ann Surg Oncol. 2011 Nov;18(12):3362-9 - PubMed
  17. World J Surg. 2012 Mar;36(3):617-22 - PubMed
  18. Exp Ther Med. 2011 Sep;2(5):879-885 - PubMed
  19. Semin Cancer Biol. 2013 Jun;23(3):159-70 - PubMed
  20. Med Oncol. 2013;30(3):596 - PubMed
  21. World J Surg Oncol. 2013 May 24;11:112 - PubMed
  22. BMC Cancer. 2013 Jul 22;13:350 - PubMed
  23. Int J Cancer. 2014 Sep 1;135(5):1178-86 - PubMed
  24. World J Surg Oncol. 2014 Mar 19;12:58 - PubMed
  25. Atherosclerosis. 2014 May;234(1):206-13 - PubMed
  26. Cancer Epidemiol Biomarkers Prev. 2014 Jul;23(7):1204-12 - PubMed
  27. J Natl Cancer Inst. 2014 May 29;106(6):dju124 - PubMed
  28. J Surg Oncol. 2014 Sep;110(3):333-40 - PubMed
  29. Dig Liver Dis. 2014 Sep;46(9):846-53 - PubMed
  30. Front Immunol. 2014 Oct 21;5:508 - PubMed
  31. Dis Esophagus. 2016 Jan;29(1):79-85 - PubMed
  32. Dis Esophagus. 2016 Jul;29(5):403-11 - PubMed
  33. Asian Pac J Cancer Prev. 2015;16(6):2245-50 - PubMed
  34. World J Gastroenterol. 2015 May 14;21(18):5591-7 - PubMed
  35. Surg Today. 2016 Apr;46(4):405-13 - PubMed
  36. Eur J Surg Oncol. 2015 Oct;41(10):1308-15 - PubMed
  37. Am J Cancer Res. 2015 Jun 15;5(7):2180-9 - PubMed
  38. Ann Surg Oncol. 2016 Feb;23(2):646-54 - PubMed
  39. Medicine (Baltimore). 2015 Oct;94(42):e1702 - PubMed
  40. Tumour Biol. 2016 Jun;37(6):7149-54 - PubMed
  41. Sci Rep. 2015 Dec 22;5:18811 - PubMed
  42. Br J Cancer. 2015 Dec 22;113(12):1746 - PubMed
  43. Ann Oncol. 2016 Apr;27(4):687-92 - PubMed
  44. Expert Rev Cardiovasc Ther. 2016;14(5):573-7 - PubMed
  45. Eur J Cancer Care (Engl). 2017 Mar;26(2):null - PubMed
  46. J Gastrointest Oncol. 2016 Apr;7(2):189-95 - PubMed
  47. BMC Cancer. 2016 Sep 06;16:722 - PubMed
  48. Int J Clin Oncol. 2017 Jun;22(3):469-475 - PubMed
  49. Mol Clin Oncol. 2016 Dec;5(6):767-772 - PubMed
  50. Sci Rep. 2017 Feb 14;7:42581 - PubMed
  51. CA Cancer J Clin. 2018 Nov;68(6):394-424 - PubMed
  52. J Immunol. 1988 Dec 15;141(12):4395-402 - PubMed
  53. Stat Med. 1998 Dec 30;17(24):2815-34 - PubMed

Publication Types