Prognostic role of pretreatment derived neutrophil to lymphocyte ratio in urological cancers: a systematic review and meta-analysis

Abstract Background To investigate the possible prognostic role of pretreatment derived neutrophil-lymphocyte ratio (dNLR) in urological cancers, including renal cell carcinoma (RCC), prostate cancer (PCa), and urothelial cancer (UCa). Materials and methods Eligible studies were comprehensively searched from PubMed, Embase, Cochrane Library and Web of Science, up to April 2019. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess the relationships. Results A total of 12 studies embracing 6585 patients were included in the meta-analysis. Our results indicated that a higher pretreatment dNLR was associated with a decreased cancer-specific survival (CSS, HR 2.67, 95% CI 1.06–6.71, P = 0.037) and disease-free survival (DFS, HR 2.02, 95% CI 1.03–3.94, P = 0.040) in RCC, but not for overall survival (OS, HR 1.05, 95% CI 0.71–1.53, P = 0.818). A higher dNLR was associated with an inferior biochemical recurrence-free survival (BRFS, HR 1.70, 95% CI 1.00–2.87, P = 0.049) and OS (HR 1.35, 95% CI 1.20–1.51, P  Conclusion A higher dNLR level was negatively associated with OS, CSS, DFS and BRFS, forecasting that it could be an independent prognosis predictor in urological cancers.