BACKGROUND: Presence of a high neutrophil-to-lymphocyte ratio (NLR) has been associated with increased mortality in several @entity5 . Here, we quantify the effect of NLR on survival in @entity1 with @entity5 , and examine the effect of clinico-pathologic factors on its prognostic value. METHODS: A systematic search of electronic databases was conducted to identify publications exploring the association of pre-treatment blood NLR with @entity1349 ( @entity1349 ) and event-free survival (EFS) among @entity1 with @entity43 . Data from studies reporting a hazard ratio (HR) and 95% confidence interval (CI) or a p-value (P) were weighted by generic inverse-variance and pooled in a random effects meta-analysis. Subgroup analyses were conducted according to primary @entity5 type. Meta-regression was performed to evaluate the influence of clinico-pathologic factors on the HR for @entity1349 and EFS. All statistical tests were two-sided. RESULTS: Twenty-six studies comprising 10,530 @entity1 were included. Studies used different cut-offs to classify high NLR (range 0.89 to 5.03). The median cut-off for high NLR was 2.95 among twenty-six studies reporting a HR for @entity1349 , and 2.79 in seventeen studies reporting EFS outcomes. NLR greater than the cut-off was associated with worse @entity1349 (HR 1.65, 95% CI=1.44 to 1.89; P<0.001) and EFS (HR 1.57, 95% CI=1.35 to 1.82; P<0.001). This association was present in all @entity5 types. Most studies were comprised of @entity1 with both early-stage and advanced disease. In @entity5 , significant associations between NLR and @entity1349 were observed in studies of early- and mixed-stage @entity1 and regression analysis showed a greater magnitude of effect in @entity1 with locally advanced disease and in those who received both chemotherapy and radiation. CONCLUSIONS: High NLR is associated with an adverse @entity1349 and EFS in @entity1 with gynecologic @entity5 .

Is the neutrophil-to-lymphocyte ratio prognostic of survival outcomes in XXXX ? A systematic review and meta-analysis.

@entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'gynecologic cancers', 'cervical cancer', 'malignancies'] @entity1 :: ('9606', 'Species') :: ['patients'] @entity43 :: ('MESH:D010051', 'Disease') :: ['ovarian, endometrial and cervical cancers'] @entity1349 :: ('MESH:D011475', 'Disease') :: ['OS', 'overall survival']
@entity5 :: (MESH:D009369,Disease) :: ['gynecologic cancers']
