Abstract: Background and purpose: It has been found that the platelet-to-lymphocyte ratio (PLR) can predict clinical outcomes of nasopharyngeal carcinoma (NPC). However, its prognostic value in patients with NPC remains controversial. The aim of this study was to assess its prognostic value in NPC. Methods: We searched PubMed, Web of Science and Scopus databases to identify studies evaluating the prognostic value of pretreatment PLR in NPC. The end points were overall survival (OS), progression-free survival (PFS), disease-specific survival (DSS) and distant metastasis-free survival (DMFS). Pooled hazard ratio (HR) and associated 95% confidence interval (95% CI) were extracted and synthesized to examine the effects using fixed-effects/random-effects models according to the result of heterogeneity test. Results: A total of 10 studies comprising 4655 patients with NPC were included. The pooled effects of the Meta-analysis demonstrated that patients with elevated PLR had shorter OS (HR=1.92, 95% CI: 1.73-2.14, P<0.000 01), PFS (HR=1.56, 95% CI: 1.19-2.06, P=0.002) and DSS (HR=1.65, 95% CI: 1.19-2.27, P=0.002). However, there was no significant correlation between DMFS and pretreatment PLR. Conclusion: Elevated pretreatment PLR might predict poor prognosis for patients with NPC indicated by shorter OS, PFS and DSS, but not DMFS.

Key words: Meta-analysis, Nasopharyngeal carcinoma, Platelet-to-lymphocyte ratio, Prognosis