Pretreatment Platelet-lymphocyte Ratio As A Prognostic Factor In Patients With Head And Neck Squamous Cell Carcinoma: A Meta-analysis

Purpose: Pretreatment platelet-lymphocyte ratio has been reported to be associated with poorer survival in various malignancies.The purpose of this study was to quantify the prognostic impact of PLR on head and neck squamous cell carcinoma(HNSCC).Methods: Using multiple databases,a systematic search for articles evaluating the effect of PLR on prognosis of patients with HNSCC was performed.An inverse variation,random-effects model was used to analyze the data.Results: Nineteen studies enrolling 6755 patients were included in the analyses.Overall,A higher PLR was significantly associated with poorer HNSCC prognosis:pooled HR 1.72,95%CI 1.33-2.22 for overall survival(OS);pooled HR 1.29,95%CI0.89-1.85 for disease-free survival(DFS);pooled HR 1.40,95%CI 0.93-2.11 for distant metastasis-free survival(DMFS);pooled HR 1.82,95%CI 1.42-2.33 for disease-specific survival(DSS);pooled HR 1.48,95%CI 1.14-1.94 for progression-free survival(PFS);pooled HR 1.97,95%CI 1.31-2.96 for recurrence-free survival(RFS).PLR greater than the cutoff value was associated with poorer OS and PFS in patients with nasopharyngeal carcinoma(HR 1.68,95%CI 1.39-2.02 and HR1.48,95%CI 1.06-2.06,respectively)and a higher PLR was associated with poorer OS and DSS in oral cancer patients(HR 1.49,95%CI 0.88-2.50 and HR 1.96,95%CI1.39-2.76,respectively).Conclusion: Elevated PLR predicts worse outcomes in patients with HNSCC.