| Abstrakt: |
Objective: To evaluate the prognostic value of platelet-to-lymphocyte ratio (PLR) in upper tract urothelial carcinoma (UTUC) patients treated with radical nephroureterectomy. Methods: This study was pre-registered in PROSPERO (No. CRD42020186645). Two reviewers independently performed a comprehensive literature search on PubMed, Web of Science, EMBASE, Cochrane Library databases, China Biology Medicine disc (CBM), Wanfang database, and China National Knowledge Infrastructure (CNKI) from inception to May 2021 for prospective or retrospective cohort studies evaluating the prognostic value of PLR. Literature was analyzed with inclusion and exclusion criteria. Data and other useful clinicopathological features were extracted and analyzed with fixed or random-effect models when applicable. Heterogeneity was assessed on the basis of Cochran's Q test and I² statistic. Publication bias was assessed with funnel plots and precisely assessed by Egger's tests. Results: A total of ten studies involving 3 287 UTUC patients were included. Meta-analysis showed that elevated preoperative PLR was associated with worse overall survival (HR=1.51, 95%CI 1.17-1.94, P=0.001), cancer specific survival (HR=1.52, 95%CI 1.21-1.90, P<0.001), disease free survival (HR=1.32, 95%CI 1.12-1.56, P=0.001), and progression free survival (HR=1.88, 95%CI 1.41-2.52, P<0.001). Furthermore, the sensitivity analyses validated the stability and reliability of the results. Conclusion: The present meta-analysis demonstrates a significant association between elevated preoperative PLR and poor prognosis of UTUC patients treated with radical nephroureterectomy. Hence, PLR could be helpful as a potential prognostic biomarker to guide clinical decision-making and select individualized treatment strategies for UTUC patients. However, more prospective and large-scale trials are needed to provide more evidence. [ABSTRACT FROM AUTHOR] |
