Prognostic significance of neutrophil-to-lymphocyte ratio in cervical cancer: A systematic review and meta-analysis of observational studies

BACKGROUND AND AIMS: The prognostic role of neutrophil-to-lymphocyte ratio (NLR) in cervical cancer are controversial. We conducted this meta-analysis to obtain a more accurate assessment of prognostic significance of NLR in cervical cancer. RESULTS: A total of 9 studies, consisting of 2,804 patients, were selected in this meta-analysis. Our pooled results showed that high pre-treatment NLR level was significantly associated with poorer overall survival (HR: 1.88, 95% CI 1.30–2.73) and shorter progression free survival (HR 1.65, 95% CI 1.18–2.29). Additionally, increased NLR was also significantly correlated with tumor size (OR 2.05, 95% CI 1.14–3.65), advanced FIGO stage (OR 2.12, 95% CI1.28–3.49) and lymph node involvement (OR 2.24, 95% CI 1.65–3.04). MATERIALS AND METHODS: We conducted a systematic literature search using the electronic databases PubMed, Web of Science, and Embase up to May 2016.Statistical analysis was performed using Stata 10.0. CONCLUSIONS: Elevated pretreatment NLR could serve as a predicative factor of poor prognosis for cervical cancer patients.