Neutrophil to lymphocyte ratio and cancer prognosis: an umbrella review of systematic reviews and meta-analyses of observational studies.

BMC Medicine
Meghan A CuppAntonio J Berlanga-Taylor

Abstract

Although neutrophils have been linked to the progression of cancer, uncertainty exists around their association with cancer outcomes, depending on the site, outcome and treatments considered. We aimed to evaluate the strength and validity of evidence on the association between either the neutrophil to lymphocyte ratio (NLR) or tumour-associated neutrophils (TAN) and cancer prognosis. We searched MEDLINE, Embase and Cochrane Database of Systematic Reviews from inception to 29 May 2020 for systematic reviews and meta-analyses of observational studies on neutrophil counts (here NLR or TAN) and specific cancer outcomes related to disease progression or survival. The available evidence was graded as strong, highly suggestive, suggestive, weak or uncertain through the application of pre-set GRADE criteria. A total of 204 meta-analyses from 86 studies investigating the association between either NLR or TAN and cancer outcomes met the criteria for inclusion. All but one meta-analyses found a hazard ratio (HR) which increased risk (HR > 1). We did not find sufficient meta-analyses to evaluate TAN and cancer outcomes (N = 9). When assessed for magnitude of effect, significance and bias related to heterogeneity and small study effects, 18...Continue Reading

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Citations

Jan 14, 2021·Journal of Clinical Medicine·Tomonari Kinoshita, Taichiro Goto
Mar 28, 2021·Internal and Emergency Medicine·Bernadette Corica, Giulio Francesco Romiti
Apr 4, 2021·Diagnostics·Alexios-Fotios A MentisGeorgina Tzanakaki
May 10, 2021·Liver International : Official Journal of the International Association for the Study of the Liver·Won-Mook ChoiKang Mo Kim
Jul 3, 2021·International Journal of Molecular Sciences·Fabrice TolleSabrina Bréchard
Jul 14, 2021·Transplantation and Cellular Therapy·Muhammad Umair MushtaqJoseph P McGuirk
Aug 18, 2021·Laryngoscope Investigative Otolaryngology·Paolo Boscolo-RizzoGiancarlo Tirelli

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Software Mentioned

RefWorks
AMSTAR
Stata
ggplot2
R package “ meta ”
meta
Quality in Prognostic Studies ( QUIPS )
QUIPS
R
Umbrella

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