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Prognostic significance of neutrophil-to-lymphocyte ratio in rectal cancer: a meta-analysis

Authors Dong Y, Shi Y, He L, Su P

Received 23 December 2015

Accepted for publication 8 April 2016

Published 25 May 2016 Volume 2016:9 Pages 3127—3134


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 3

Editor who approved publication: Professor Min Li

Yi-wei Dong,1,* Yan-qiang Shi,1,* Li-wen He,1,* Pei-zhu Su2

1The Second Clinical Medical School, Southern Medical University, 2Department of Gastroenterology, Zhujiang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, People’s Republic of China

*These authors contributed equally to this work

Background: Inflammatory responses play decisive roles in tumor development, immune surveillance, and responses to therapy. High neutrophil-to-lymphocyte ratio (NLR), as an inflammation index, has been reported to be a predictor for poor prognosis of various cancers. The purpose of this meta-analysis was to evaluate the prognostic value of NLR in patients with rectal cancer.
Methods: A comprehensive search of the literature was conducted through PubMed and EMBASE. Pooled hazard ratio (HR) with 95% confidence interval (CI) was used to evaluate the association between NLR and three outcomes: overall survival, disease-free survival, and recurrence-free survival.
Results: Seven cohorts involving 959 patients were included in this meta-analysis. Our pooled results demonstrated that elevated NLR was associated with poor overall survival (HR: 13.41, 95% CI: 4.90–36.72), disease-free survival (HR: 4.37, 95% CI: 2.33–8.19), and recurrence-free survival (HR: 3.64, 95% CI: 1.88–7.05).
Conclusion: An elevated NLR is a valuable and easily available prognostic marker for rectal cancer. It is associated with unfavorable overall survival, disease-free survival, and recurrence-free survival. NLR could be a useful candidate factor for making treatment decisions for individual patients with rectal cancer.

Keywords: neutrophil-to-lymphocyte ratio, rectal cancer, prognosis, meta-analysis, overall survival, disease-free survival

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