PT - JOURNAL ARTICLE AU - Lixiao Yang AU - Huixiao Chen TI - Establishing the prognostic value of platelet-to-lymphocyte ratio in cervical cancer: a systematic review and meta-analysis AID - 10.1136/ijgc-2018-000090 DP - 2019 May 01 TA - International Journal of Gynecologic Cancer PG - 683--690 VI - 29 IP - 4 4099 - http://ijgc.bmj.com/content/29/4/683.short 4100 - http://ijgc.bmj.com/content/29/4/683.full SO - Int J Gynecol Cancer2019 May 01; 29 AB - Objective The aim of this study was to conduct a meta-analysis to establish the prognostic value of platelet-to-lymphocyte ratio in cervical cancer.Methods We conducted a search in Medline and Embase datasets for articles published until May 1, 2018 to perform a meta-analysis to establish the prognostic value of platelet-to-lymphocyte ratio in cervical cancer. The primary survival outcomes were overall survival and progression-free survival. The pooled hazard ratios (HRs) and 95% confidence intervals (95% CIs) were combined to calculate overall effects. Cochran’s Q test and Higgins’ I2 statistics were employed to estimate the heterogeneity. In addition, the subgroup analysis, sensitivity analysis, and meta-regression were performed to identify the source of heterogeneity. Egger’s linear regression test and Begg’s funnel plot and the trim and fill methods were employed to evaluate the publication bias.Results A total of 2616 patients from eight studies were enrolled in the meta-analysis. Significant association was observed between elevated platelet-to-lymphocyte ratio and a worse overall survival, with a combined HR of 1.49 (95% CI 1.24 to 1.79, I2=32.8%). Elevated platelet-to-lymphocyte ratio was significantly associated with a worse progression-free survival, with a combined HR of 1.65 (95% CI 1.17 to 2.33, I2 = 49.4%). Subsequently, sensitivity analysis, subgroup analysis, and meta-regression model containing six predominant factors were applied to trace the origin of heterogeneity. However, no significant factors or studies were explored as the potential source of heterogeneity.Conclusion Elevated pre-treatment platelet-to-lymphocyte ratio may be an adverse prognostic factor for overall survival and progression-free survival in patients with cervical cancer. Further investigations are warranted to determine the exact mechanism by which platelet-to-lymphocyte ratio impacts survival outcomes in cervical cancer.