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REVIEW article

Front. Oncol.
Sec. Cancer Epidemiology and Prevention
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1404711
This article is part of the Research Topic The Future of Cancer Surveillance Research View all 16 articles

Association between preoperative neutrophil to lymphocyte ratio and the survival outcomes of esophageal cancer patients underwent esophagectomy: a systematic review and meta-analysis

Provisionally accepted
Xun Wu Xun Wu Sijie Liu Sijie Liu *Fengwei Li Fengwei Li *Yingtai Chen Yingtai Chen *
  • Department of Thoracic Surgery, Beijing Aerospace General Hospital, Beijing, China

The final, formatted version of the article will be published soon.

    Objectives: To assess the association between preoperative neutrophil to lymphocyte ratio (NLR) and the survival outcomes of esophageal cancer patients underwent esophagectomy, the latest and comprehensive systematic review performed. Methods: Related literature retrieved from PubMed, Web of Science, Embase, and Cochrane before January, 2024, according to the inclusion criteria. Outcomes measured were overall survival (OS), disease-free survival (DFS), relapse-free survival (RFS), and cancer-specific survival (CSS). Results: Eighteen studies with 6119 esophageal cancer patients were retained for analysis. Meta-analysis demonstrated that OS (HR: 1.47; 95% CI: 1.29, 1.67; P ＜0.00001), DFS (HR: 1.62; 95% CI: 1.29, 2.05; P ＜0.0001) and CSS (HR: 1.62; 95% CI: 1.29, 2.05; P ＜0.0001) were significantly shorter in the high NLR group compared with the low NLR group. In addition, meta-analysis revealed a similar RFS (HR: 1.47; 95% CI: 0.92, 2.35; P = 0.10) among the two groups. Subgroup analysis of OS and DFS based on mean/median age, NLR cut-off and region found that all subgroups remained significant difference between two groups. Conclusions: Among esophageal cancer patients underwent esophagectomy, preoperative NLR can be used as prognostic factor independently. High preoperative NLR is associated with poor prognosis. More large-scale, multicenter, prospective clinical studies are needed to further validate the relationship between preoperative NLR and prognosis of esophageal cancer.

    Keywords: Neutrophil, lymphocyte, NLR, esophageal cancer, Esophagectomy, Meta-analysis

    Received: 21 Mar 2024; Accepted: 26 Jul 2024.

    Copyright: © 2024 Wu, Liu, Li and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Sijie Liu, Department of Thoracic Surgery, Beijing Aerospace General Hospital, Beijing, China
    Fengwei Li, Department of Thoracic Surgery, Beijing Aerospace General Hospital, Beijing, China
    Yingtai Chen, Department of Thoracic Surgery, Beijing Aerospace General Hospital, Beijing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.