Prognostic value of neutrophil/lymphocyte, platelet/lymphocyte, lymphocyte/monocyte ratios and Glasgow prognostic score in osteosarcoma: A meta-analysis

BACKGROUND: Some studies investigated the prognostic role of several blood biomarkers, including the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR) and Glasgow prognostic score (GPS), in osteosarcoma, but their results were inconsistent with each other. AIM: To identify the prognostic value of NLR, PLR, LMR and GPS in osteosarcoma patients through reviewing relevant studies. METHODS: The PubMed, EMBASE, Web of Science and CNKI databases were searched up to October 2, 2021. The primary and second outcomes were overall survival (OS) and disease-free survival (DFS), respectively. The hazard ratios (HRs) with 95% confidence intervals (CIs) were combined to assess the association between these indicators and prognosis of osteosarcoma patients. RESULTS: A total of 13 studies involving 2087 patients were eventually included. The pooled results demonstrated that higher NLR and GPS were significantly associated with poorer OS (HR = 1.88, 95%CI: 1.38-2.55, P < 0.001; HR = 2.19, 95%CI: 1.64-2.94, P < 0.001) and DFS (HR = 1.67, 95%CI: 1.37-2.04, P < 0.001; HR = 2.50, 95%CI: 1.39-4.48, P < 0.001). However, no significant relationship of PLR and LMR and OS (P = 0.085; P = 0.338) and DFS (P = 0.396; P = 0.124) was observed. CONCLUSION: Higher NLR and GPS were related with worse prognosis and might serve as novel prognostic indicators for osteosarcoma patients.