Neutrophil-to-lymphocyte ratio as a prognostic indicator in head and neck cancer: A systematic review and meta-analysis

Head Neck. 2018 Nov;40(11):2546-2557. doi: 10.1002/hed.25324. Epub 2018 May 14.

Abstract

Background: The purposes of this systematic review and meta-analysis were to investigate the relationship between the neutrophil-to-lymphocyte ratio (NLR) and prognosis in head and neck cancer.

Methods: A systematic review and meta-analysis were done to investigate the role of NLR in overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), and progression-free survival (PFS).

Results: For qualitative analysis, 33 cohorts with over 10 072 patients were included. For quantitative analysis, 15 studies were included with 5562 patients. The pooled data demonstrated that an elevated NLR significantly predicted poorer OS and DSS.

Conclusion: An elevated pretreatment NLR is a prognostic marker for head and neck cancer. It represents a simple and easily obtained marker that could be used to stratify groups of high-risk patients who might benefit from adjuvant therapy.

Keywords: head and neck cancer; inflammatory markers; meta-analysis; neutrophil lymphocyte ratio (NLR); prognosis; systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Biomarkers, Tumor / blood*
  • Carcinoma, Squamous Cell / blood*
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / therapy
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms / blood*
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / therapy
  • Humans
  • Leukocyte Count
  • Lymphocyte Count
  • Lymphocytes / cytology
  • Male
  • Neutrophils / cytology
  • Prognosis
  • Survival Analysis

Substances

  • Biomarkers, Tumor