Prognostic Value of the Neutrophil-To-Lymphocyte Ratio in Patients with Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.
Yan Wang, Chen Peng, Wei Ding et al.
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In 30 seconds
This systematic review and meta-analysis examined whether preoperative neutrophil-to-lymphocyte ratio (NLR) was associated with postoperative survival in people with oral squamous cell carcinoma (OSCC). It included 30 studies; higher NLR was associated with poorer overall survival (HR 1.79, 95% CI 1.48-2.16), disease-free survival (HR 1.70, 95% CI 1.48-1.94), and disease-specific survival (HR 2.10, 95% CI 1.72-2.57). No significant association was found for progression-free survival. The authors considered NLR a potential low-cost prognostic marker but called for further high-quality research.
Key findings
- Higher preoperative NLR was associated with poorer overall survival (HR 1.79, 95% CI 1.48-2.16; P < .001).
- Higher NLR was associated with poorer disease-free survival (HR 1.70, 95% CI 1.48-1.94; P < .001) and disease-specific survival (HR 2.10, 95% CI 1.72-2.57; P < .001).
- NLR was not significantly associated with progression-free survival (HR 1.24; 95% CI 0.78-1.99; P = .367).
- Publication bias was detected for overall, disease-free, and disease-specific survival; trim-and-fill analyses did not reverse the pooled effect directions.
Why it matters
A routinely measurable, low-cost blood ratio associated with several survival outcomes could contribute to prognostic assessment in OSCC. The findings may help frame further evaluation of NLR alongside established clinical information, but the associations do not establish that NLR causes poorer outcomes or that using it improves decisions or survival.
What to keep in mind
The authors note that the number of included studies was limited and that high-quality research is needed. Publication bias was detected for overall, disease-free, and disease-specific survival.