Potential value of pretreatment neutrophil-to-lymphocyte ratio in patients with bone sarcomas

Abstract Background Increasing evidence indicates the important value of the neutrophil-to-lymphocyte ratio (NLR) in various cancers. In this meta-analysis, we will explore the potential role of pretreatment NLR in patients with bone sarcomas. Methods A systematic literature search of the PubMed, Embase and Web of Science databases for relevant articles was performed with the deadline of December 29, 2019. The hazard ratio (HR) and its 95% confidence interval (CI) were calculated to evaluate the association between NLR and overall survival (OS) in patients with bone sarcomas. Results A total of 1131 patients in 6 studies were included in this meta-analysis. The pooled HR of 2.26 (95%CI: 1.83-2.69, p<0.001) indicated that an elevated NLR had an unfavourable effect on OS. Subgroup analyses showed that elevated NLR was related to poor OS in patients with bone sarcomas, regardless of the type of cancer, ethnicity, sample size (≥200 or <200), the cut-off value for NLR (≥3 or <3), follow-up time (≥30 or <30) and paper quality (NOS scores ≥8 or <8). Additionally, the results of diagnosis analysis suggested that NLR had a relatively high diagnostic accuracy for bone sarcoma patients. Conclusion The results of this meta-analysis suggest that an elevated NLR is associated with poor survival of patients with bone sarcomas. Moreover, NLR had a relatively high diagnostic accuracy for bone sarcoma patients. All these findings suggest NLR might be a promising biomarker in the management of bone sarcomas.